OrganizationActive
Healtheast Care System
NPI 1336310283 · Non-Pharmacy Dispensing Site · Saint Paul, MN
Provider details
- NPI number
- 1336310283
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Medvantx, Inc.
- Organization subpart
- Yes
- Authorized official
- Kenny Heine, Director of Operations(858) 625-2990
- License
- PY32377 (MN)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1690 University Ave W
Suite 570
Saint Paul, MN 55104-3723
Phone: (651) 232-4800
Street-level locationGet directions
Mailing address
5626 Oberlin Dr
San Diego, CA 92121-1705
Other names (DBA / former)
- Doing business as
- Healtheast - Midway Clinic
Registry dates
- Enumerated
- 2008-03-19
- Last updated
- 2012-10-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.