Victory Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

VICTORY MEDICAL SUPPLY, LLC

Practice address

140 N 100 E
American Fork, UT 84003-1735

Phone

(801) 770-0520

Fax

(801) 770-0922

NPI assigned

May 5, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Nathan T Johns

Title

President

Phone

(801) 770-0520

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588636800000",
    "number": "1073134649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13894 S BANGERTER PKWY STE 200",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205320",
            "telephone_number": "801-770-0520",
            "fax_number": "801-770-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 N 100 E",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840031735",
            "telephone_number": "801-770-0520",
            "fax_number": "801-770-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A",
        "authorized_official_last_name": "JOHNS",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-770-0520",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL PROVIDER #",
            "identifier": "626888500",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.victorymedsupply.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "140 N 100 E",
            "city": "American Fork",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840031735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in American Fork, UT
• Providers in American Fork, UT by specialty
• Durable Medical Equipment & Medical Supplies in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; 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.