OrganizationActive
Changebridge Medical Associates, PA
NPI 1760757884 · Non-Pharmacy Dispensing Site · Montville, NJ
Provider details
- NPI number
- 1760757884
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Medvantx, Inc.
- Organization subpart
- Yes
- Authorized official
- Kenny Heine, Sr Director Ops(858) 964-1506
- License
- 25MA04449000 (NJ)
Specialties & taxonomies
Suppliers
Practice location
170 Changebridge Rd
C-3
Montville, NJ 07045-9115
Phone: (973) 575-5540
Approximate (ZIP-level) locationGet directions
Mailing address
5626 Oberlin Dr
San Diego, CA 92121-1705
Registry dates
- Enumerated
- 2012-03-22
- Last updated
- 2012-10-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.