OrganizationActive
Annandale Family Practice LLC
NPI 1467793141 · Non-Pharmacy Dispensing Site · Lebanon, NJ
Provider details
- NPI number
- 1467793141
- 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
- 25MA07764100 (NJ)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(78/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 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
56 Payne Rd
Suite 21
Lebanon, NJ 08833-3262
Phone: (908) 238-0100
Street-level locationGet directions
Mailing address
5626 Oberlin Dr
San Diego, CA 92121-1705
Other names (DBA / former)
- Doing business as
- Annandale Family Practice
Registry dates
- Enumerated
- 2013-03-06
- Last updated
- 2013-03-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.