Provider Demographics
NPI:1427001585
Name:VANTAGE DME
Entity Type:Organization
Organization Name:VANTAGE DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:LOU
Authorized Official - Last Name:BERKOBEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-548-5463
Mailing Address - Street 1:229 PORTERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ELLWOOD CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16117-2431
Mailing Address - Country:US
Mailing Address - Phone:724-752-1562
Mailing Address - Fax:724-752-1564
Practice Address - Street 1:229 PORTERSVILLE RD
Practice Address - Street 2:
Practice Address - City:ELLWOOD CITY
Practice Address - State:PA
Practice Address - Zip Code:16117-2431
Practice Address - Country:US
Practice Address - Phone:724-752-1562
Practice Address - Fax:724-752-1564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1103530007Medicare NSC