# VANTAGE DME

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Vantage Home Respiratory Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104828409
- **Authorized official:** MR. RANDAL JAMES POULSON CRTT (V.P. REIMBURSEMENT)
- **Authorized official phone:** (813) 333-9449

## Contact information

- **Practice address:** 3 ORTHOPAEDIC DRIVE, GREENVILLE, PA 16125
- **Practice address phone:** (724) 589-5540
- **Practice address fax:** (724) 589-5543
- **Mailing address:** 3 ORTHOPAEDIC DRIVE, GREENVILLE, PA 16125
- **Mailing address phone:** (724) 589-5540
- **Mailing address fax:** (724) 589-5543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | PA | Yes |

## Other

- **Enumeration date:** 06/01/2005
- **Last updated:** 08/22/2020