OrganizationActive
Upmc Community Medcine Inc
NPI 1235538828 · Non-Pharmacy Dispensing Site · Andover, OH
Provider details
- NPI number
- 1235538828
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Medvantx, Inc.
- Organization subpart
- Yes
- Authorized official
- Kenny Heine, Vp of Operations(858) 964-1506
- License
- 34.004448 (OH)
Specialties & taxonomies
Suppliers
Practice location
149 E Main St
Andover, OH 44003-9479
Phone: (440) 293-5555
Approximate (ZIP-level) locationGet directions
Mailing address
5626 Oberlin Dr
San Diego, CA 92121-1705
Other names (DBA / former)
- Doing business as
- Lakeside Family Medicine Andover
Registry dates
- Enumerated
- 2014-08-19
- Last updated
- 2014-08-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.