Ehpp Chestnut Ridge LLC
NPI #1992940068 in Latrobe, Pennsylvania
Provider Information
- NPI Number
- 1992940068
- Entity Type
- Organization
- Organization Name
- Ehpp Chestnut Ridge LLC
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MEDVANTX, INC.
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- Dec 3, 2008
- Last Updated
- Oct 23, 2012
Practice Location
- Address
- 911 LIGONIER ST
- Address 2
- 101
- City
- Latrobe
- State
- Pennsylvania
- ZIP Code
- 15650-1805
- Phone
- (725) 537-8518
Authorized Official
- Name
- KENNY HEINE
- Title
- DIRECTOR OF OPERATIONS
- Phone
- (858) 625-2990
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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