OrganizationActive
Ehpp Chestnut Ridge LLC
NPI 1437394558 · Non-Pharmacy Dispensing Site · Latrobe, PA
Provider details
- NPI number
- 1437394558
- 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
- MD033841 (PA)
Specialties & taxonomies
Suppliers
Practice location
555 Route 217
Suite 1
Latrobe, PA 15650-3428
Phone: (724) 694-2723
Approximate (ZIP-level) locationGet directions
Mailing address
5626 Oberlin Dr
San Diego, CA 92121-1705
Other names (DBA / former)
- Doing business as
- Excela Chestnut Ridge Derry
Registry dates
- Enumerated
- 2008-12-03
- Last updated
- 2012-10-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.