NPIMap

Organization Active NPI

Victory Discount Pharmacy Inc

  • Community/Retail Pharmacy
  • N Hollywood, CA
National Provider Identifier
1235126038
Registry record updated Sep 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY41446 Issued in CA
Legal business name
VICTORY DISCOUNT PHARMACY INC
Doing business as
VICTORY DISCOUNT PHARMACY
Practice address
12922 Victory Blvd
Ste a
N Hollywood, CA 91606-2924
Phone
(818) 752-9888
Fax
(818) 752-0492
NPI assigned
Oct 5, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2010

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

Authorized official

Name
Farhad YassiniNPI 1497805634
Title
Pic and President
Phone
(818) 752-9888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PHY41446 CA Primary

Addresses

Primary practice location

12922 Victory Blvd
Ste a
N Hollywood, CA 91606-2924

Mailing address

12922 Victory Blvd
Ste a
N Hollywood, CA 91606-2924
Phone (818) 752-9888

Other identifiers 2

IdentifierTypeStateIssuer
0532641OtherNCPDP PROVIDER IDENTIFICATION NUMBER
PHA414460MedicaidCA

Other names 1

  • VICTORY DISCOUNT PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

12922 Victory Blvd
#A
North Hollywood, CA 91606
Phone (818) 752-9888

12922A Victory Blvd
North Hollywood, CA 91606
Phone (818) 752-9888

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284681600000",
    "number": "1235126038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12922 VICTORY BLVD",
            "address_2": "STE A",
            "city": "N HOLLYWOOD",
            "state": "CA",
            "postal_code": "916062924",
            "telephone_number": "818-752-9888",
            "fax_number": "818-752-0492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12922 VICTORY BLVD",
            "address_2": "STE A",
            "city": "N HOLLYWOOD",
            "state": "CA",
            "postal_code": "916062924",
            "telephone_number": "818-752-9888",
            "fax_number": "818-752-0492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY DISCOUNT PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2010-09-17",
        "status": "A",
        "authorized_official_last_name": "YASSINI",
        "authorized_official_first_name": "FARHAD",
        "authorized_official_title_or_position": "PIC AND PRESIDENT",
        "authorized_official_telephone_number": "818-752-9888"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY41446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0532641",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA414460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VICTORY DISCOUNT PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in N Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2010; 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.