Provider Demographics
NPI:1619177359
Name:VANTAGE MOBILE SERVICES
Entity Type:Organization
Organization Name:VANTAGE MOBILE SERVICES
Other - Org Name:VANTAGE DIAGNOSTIC SLEEP SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DELMAR
Authorized Official - Last Name:MOSBACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-337-0000
Mailing Address - Street 1:1305 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-8378
Mailing Address - Country:US
Mailing Address - Phone:814-337-0000
Mailing Address - Fax:814-337-0479
Practice Address - Street 1:1305 S. MAIN ST
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-8378
Practice Address - Country:US
Practice Address - Phone:814-337-0000
Practice Address - Fax:814-337-0479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic