Victory Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

46843 Issued in CA

Legal business name

VICTORY MEDICAL SUPPLY

Practice address

6411 Sepulveda Blvd
Ste 1J
Van Nuys, CA 91411-1304

Phone

(818) 997-6968

Fax

(818) 997-6946

NPI assigned

Mar 14, 2007

Organization subpart

No

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

Authorized official

Name

Omar Moyosore Olaofe

Title

Ceo

Phone

(818) 997-6968

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1316070550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6411 SEPULVEDA BLVD",
            "address_2": "STE 1J",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111304",
            "telephone_number": "818-997-6968",
            "fax_number": "818-997-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6411 SEPULVEDA BLVD",
            "address_2": "STE 1J",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914111304",
            "telephone_number": "818-997-6968",
            "fax_number": "818-997-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "OLAOFE",
        "authorized_official_first_name": "OMAR",
        "authorized_official_middle_name": "MOYOSORE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-997-6968"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "CA",
            "license": "46843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victory Help Outpatient Drug and Alcohol
• Victory Help Outpatient Drug and Alcohol Program
• Victory Hospice
• Victory Hospice Care Services, Inc.
• Victory Medical Clinic
• Victory Place Hospice Inc
• Christer Ann Vidal
• Victoria Elizabeth Vides Lopez, M.S., CCC-SLP
• Kaylind Viescas
• Vigilance Home Health Inc

• Durable Medical Equipment & Medical Supplies in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.