NPIMap

Organization Active NPI

Vantage DME

  • Oxygen Equipment & Supplies (DME)
  • Greenville, PA
National Provider Identifier
1104828409
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
Legal business name
VANTAGE DME
Practice address
3 Orthopaedic Drive
Greenville, PA 16125
Phone
(724) 589-5540
Fax
(724) 589-5543
NPI assigned
Jun 1, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Randal James Poulson, CRTT
Title
V.P. Reimbursement
Phone
(813) 333-9449

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X PA Primary

Addresses

Primary practice location

3 Orthopaedic Drive
Greenville, PA 16125

Mailing address

3 Orthopaedic Drive
Greenville, PA 16125
Phone (724) 589-5540

Other names 1

  • Vantage Home Respiratory Services Doing business as

National Provider Directory

National Provider Directory

Member of 5

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104828409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ORTHOPAEDIC DRIVE",
            "city": "GREENVILLE",
            "state": "PA",
            "postal_code": "16125",
            "telephone_number": "724-589-5540",
            "fax_number": "724-589-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ORTHOPAEDIC DRIVE",
            "city": "GREENVILLE",
            "state": "PA",
            "postal_code": "16125",
            "telephone_number": "724-589-5540",
            "fax_number": "724-589-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANTAGE DME",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POULSON",
        "authorized_official_first_name": "RANDAL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "V.P. REIMBURSEMENT",
        "authorized_official_telephone_number": "813-333-9449",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CRTT"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vantage Home Respiratory Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.