| Organization Name: | VICTORY DISTRIBUTORS, LLC |
| NPI Number: | 1619100740 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ELWEN EATON (PHARMACY INSURANCE SPECIALIST) |
| Mailing Address: | 859 Hanover St Manchester |
| State: | NH US |
| Postal Code: | 031045419 |
| Phone Number: | 6036274354 |
| Fax Number: | 6036265060 |
| 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: | 0337-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 |