Organization Name: | VICTORY HOME MEDICAL INC |
NPI Number: | 1073939278 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KAYLA G PITTMAN (OWNER) |
Mailing Address: | 731 S C C Duson St Eunice |
State: | LA US |
Postal Code: | 705355407 |
Phone Number: | 3374575040 |
Fax Number: | 3374570076 |
NPI Enumeration Date: | 03/12/2014 |
NPI Last Update Date: | 03/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |