NPIMap

Organization Active NPI

Victory Pharmacy

  • Pharmacy
  • Decatur, IL
National Provider Identifier
1285943829
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
VICTORY PHARMACY
Practice address
2280 E William St
Decatur, IL 62521-1528
Phone
(217) 422-1000
Fax
(217) 422-2658
NPI assigned
Sep 30, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Authorized official

Name
Mr. Wole K Adeoye, R.PH
Title
President
Phone
(217) 428-4000

Specialties & licenses 2

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

Addresses

Primary practice location

2280 E William St
Decatur, IL 62521-1528

Mailing address

163 N Water St
Decatur, IL 62523-1309
Phone (217) 428-4000

National Provider Directory

National Provider Directory
Tax ID family
Victory Pharmacy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

163 N Water St
Decatur, IL 62523
Phone (217) 428-4000

2280 E William St
Decatur, IL 62521
Phone (217) 422-1000

NPI Registry JSON

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285804800000",
    "number": "1285943829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 N WATER ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625231309",
            "telephone_number": "217-428-4000",
            "fax_number": "217-429-8651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2280 E WILLIAM ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625211528",
            "telephone_number": "217-422-1000",
            "fax_number": "217-422-2658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-30",
        "last_updated": "2010-09-30",
        "status": "A",
        "authorized_official_last_name": "ADEOYE",
        "authorized_official_first_name": "WOLE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-428-4000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.