Provider Demographics
NPI:1164880472
Name:VANTAGE MOBILITY INTERNATIONAL, LLC
Entity Type:Organization
Organization Name:VANTAGE MOBILITY INTERNATIONAL, LLC
Other - Org Name:VMI MOBILITY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:BARONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-304-3266
Mailing Address - Street 1:5202 S 28TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85040-3799
Mailing Address - Country:US
Mailing Address - Phone:602-304-3282
Mailing Address - Fax:
Practice Address - Street 1:5202 S 28TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-3799
Practice Address - Country:US
Practice Address - Phone:602-304-3282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment