MEDICARE: VERTIGON LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1194927210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VERTIGON LLC

Provider Business Mailing Address
First Line	:	1000 MEADE ST STE 202
Second Line	:
City	:	DUNMORE
State	:	PA
Zip	:	18512-3197
Country	:	US
Telephone Number	:	570-342-0800
Fax Number	:	570-969-1200

Provider Business Practice Location Address
First Line	:	1000 MEADE ST STE 202
Second Line	:
City	:	DUNMORE
State	:	PA
Zip	:	18512-3197
Country	:	US
Telephone Number	:	570-342-0800
Fax Number	:	570-969-1200

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOE P POTELUNAS
Credential	:
Telephone Number	:	570-237-0349

Provider Enumeration Date	:	06/01/2007
Last Update Date	:	08/22/2020

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Directions to “VERTIGON LLC ” Practice Location

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