OrganizationActive
Island Medical PA
NPI 1639587801 · Non-Pharmacy Dispensing Site · Ship Bottom, NJ
Provider details
- NPI number
- 1639587801
- 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
- 25MA05374000 (NJ)
Specialties & taxonomies
Suppliers
Practice location
1812 Long Beach Blvd
Ship Bottom, NJ 08008-4443
Phone: (609) 494-2323
Approximate (ZIP-level) locationGet directions
Mailing address
5626 Oberlin Dr
San Diego, CA 92121-1705
Registry dates
- Enumerated
- 2014-07-31
- Last updated
- 2014-07-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.