Victory Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

VICTORY MEDICAL SUPPLY LLC

Practice address

1320 SE Federal Hwy Ste 211
Stuart, FL 34994-3410

Phone

(772) 210-2860

NPI assigned

Jul 29, 2019

Organization subpart

No

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

Authorized official

Name

Robert Leon Smith III

Title

Owner

Phone

(940) 378-5555

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603065600000",
    "number": "1184278079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 SE FEDERAL HWY STE 211",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943410",
            "telephone_number": "772-210-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 SE FEDERAL HWY STE 211",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943410",
            "telephone_number": "772-210-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-29",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A",
        "authorized_official_last_name": "SMITH III",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-378-5555"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coralie Viaud
• Jean Aukerman Vickers, M.D.
• Lee Vickers
• Tanya Hurley Vickers, MA, CCC-SLP
• Ralph Jeftey Victor
• Starr Vida
• Valeria Marcela Vidal
• Maile Yuka Vidales
• Jonah Alexander Vidaurre
• Christina Mayoree Vigo

• Durable Medical Equipment & Medical Supplies in Stuart, FL
• Providers in Stuart, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.