Victa LLC

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

VICTA LLC

Practice address

110 Elmwood Ave
Providence, RI 02907-2423

Phone

(401) 300-5757

Fax

(401) 300-5656

NPI assigned

Dec 16, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Alexander Donoyan, MBA, LCDP

Title

Ceo

Phone

(401) 300-5757

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Victa LLC2 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.

• Victapharm

  • Pharmacy
  • Providence, RI
  • NPI 1265191118
  NPD tax ID

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550707200000",
    "number": "1457822413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 ELMWOOD AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029072423",
            "telephone_number": "401-300-5757",
            "fax_number": "401-300-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 ELMWOOD AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029072423",
            "telephone_number": "401-300-5757",
            "fax_number": "401-300-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2019-02-21",
        "status": "A",
        "authorized_official_last_name": "DONOYAN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "401-300-5757",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA, LCDP"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104317007",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Vessella, LICSW
• Paige Alexis Vetrano, PA-C
• Laura Gibbs Veyera, LICSW
• Michael P Vezeridis, MD
• Victa LLC
• Victapharm
• Victoria Sokolowski, LLC
• Sandra Victorino, LMHC
• Megan Tatiana Vidal, MD
• Tatiana Vidal

• Methadone Clinic in Providence, RI
• Providers in Providence, RI by specialty
• Methadone Clinic in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.