Organization Name: | VICTORY DISTRIBUTORS, LLC |
NPI Number: | 1578796603 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELWEN EATON (PHARMACY INSURANCE SPECIALIST) |
Mailing Address: | 201 John Devine Dr Manchester |
State: | NH US |
Postal Code: | 031034034 |
Phone Number: | 6036261233 |
Fax Number: | 6036263002 |
NPI Enumeration Date: | 08/24/2009 |
NPI Last Update Date: | 11/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 0366-P |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NH |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |