Victory Pharmacy Corporation

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH26685 Issued in FL

Legal business name

VICTORY PHARMACY CORPORATION

Doing business as

Victory Pharmacy Corporation

Practice address

1003 SW 67TH Ave
West Miami, FL 33144-4757

Phone

(786) 542-5670

Fax

(786) 542-5673

NPI assigned

Feb 25, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Grethel Rojas

Title

President/Owner

Phone

(786) 542-5670

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Victory Pharmacy Corporation Doing business as

Locations

Networks

• HealthSun Health Plans Network

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417996800000",
    "number": "1063752236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 SW 67TH AVE",
            "city": "WEST MIAMI",
            "state": "FL",
            "postal_code": "331444757",
            "telephone_number": "786-542-5670",
            "fax_number": "786-542-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 SW 67TH AVE",
            "city": "WEST MIAMI",
            "state": "FL",
            "postal_code": "331444757",
            "telephone_number": "786-542-5670",
            "fax_number": "786-542-5673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY PHARMACY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-25",
        "last_updated": "2014-12-08",
        "status": "A",
        "authorized_official_last_name": "ROJAS",
        "authorized_official_first_name": "GRETHEL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "786-542-5670"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH26685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2139010",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victory Pharmacy Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in West Miami, FL
• Providers in West Miami, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.