NPIMap

Organization Active NPI

Victory Distributors LLC

  • Community/Retail Pharmacy
  • Leominster, MA
National Provider Identifier
1346358728
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
3394 Issued in MA
Legal business name
VICTORY DISTRIBUTORS LLC
Practice address
927 Merriam Avenue
Leominster, MA 01453
Phone
(978) 466-7458
Fax
(978) 466-7490
NPI assigned
Aug 27, 2006
Last updated
Apr 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Authorized official

Name
Michael Vail
Title
President and Manager
Phone
(207) 885-7454

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X 3394 MA Primary

Addresses

Primary practice location

927 Merriam Avenue
Leominster, MA 01453

Mailing address

PO Box 1000
Ms 3000
Portland, ME 04104-5005
Phone (207) 885-7454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20100930007718 MA DME Supplier - PharmacyDME Supplier - Grocery Store 3476764911 Practice locations: Leominster, MA
O20110207000024 MA Part B Supplier - Mass Immunization (Roster Biller Only) 3476764911 12 other NPIs on this enrollment
Practice locations: Chelmsford, MA; Dracut, MA; Waltham, MA
O20111006000438 MA Part B Supplier - Mass Immunization (Roster Biller Only) 3476764911 12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Leominster, MA; Lunenburg, MA; Middleboro, MA; N Brookfield, MA; Taunton, MA; Uxbridge, MA; Waltham, MA

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Hannaford Supermarket Pharmacy 8012927 Merriam Ave, Leominster, MA 01453-1200(978) 466-7458 Epoetin|Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Ostomy Supplies|Urological Supplies|Surgical Dressings Accepts assignmentParticipating since Jul 19, 2005

National Provider Directory

National Provider Directory
Tax ID family
Victory Distributors LLC27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

301 Pleasant St
#8192
Dracut, MA 01826
Phone (978) 452-5255

927 Merriam Ave
Leominster, MA 01453
Phone (978) 466-7458

777 Rogers St
Lowell, MA 01852
Phone (978) 453-7252

777 Rogers St
#8327
Lowell, MA 01852
Phone (978) 453-7257

333 Mass Ave
#8388
Lunenburg, MA 01462
Phone (978) 582-7013

193 Boston Post Rd W
Marlborough, MA 01752
Phone (508) 229-0647

193 Boston Post Rd W
#20
Marlborough, MA 01752
Phone (508) 229-0647

25 Robert Dr
South Easton, MA 02375
Phone (508) 238-4067

158 N Main St
#8014
Uxbridge, MA 01569
Phone (508) 278-2341

55 Russell St
#8017
Waltham, MA 02453
Phone (781) 642-7416

5 Colby Ct
#8181
Bedford, NH 03110
Phone (603) 622-2320

73 Fort Eddy Rd
Concord, NH 03301
Phone (603) 228-2060

73 Fort Eddy Rd
#8329
Concord, NH 03301
Phone (603) 228-2121

35 Manchester Rd
#28
Derry, NH 03038
Phone (603) 421-2596

35 Manchester Rd
Ste 28
Derry, NH 03038
Phone (603) 421-2596

859 Hanover St
#8178
Manchester, NH 03104
Phone (603) 627-4354

175 Coliseum Ave
#8186
Nashua, NH 03063
Phone (603) 889-6663

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524182400000",
    "number": "1346358728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "address_2": "MS 3000",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041045005",
            "telephone_number": "207-885-7454",
            "fax_number": "704-645-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 MERRIAM AVENUE",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-7458",
            "fax_number": "978-466-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY DISTRIBUTORS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2018-04-20",
        "status": "A",
        "authorized_official_last_name": "VAIL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT AND MANAGER",
        "authorized_official_telephone_number": "207-885-7454"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MA",
            "license": "3394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.