OrganizationActive
Derienzo Family Practice, P.C.
NPI 1982873105 · Non-Pharmacy Dispensing Site · Charleroi, PA
Provider details
- NPI number
- 1982873105
- 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
- MD053835L (PA)
Specialties & taxonomies
Suppliers
Practice location
17 Arentzen Blvd
101
Charleroi, PA 15022-1085
Phone: (724) 483-3581
Approximate (ZIP-level) locationGet directions
Mailing address
5626 Oberlin Dr
San Diego, CA 92121-1705
Registry dates
- Enumerated
- 2008-02-21
- 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.