Victory Pharmacy of Decatur Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

VICTORY PHARMACY OF DECATUR INC

Doing business as

Victory Pharmacy

Practice address

2024 W 79TH St
Chicago, IL 60620-5720

Phone

(773) 994-2845

Fax

(773) 482-2008

NPI assigned

Aug 29, 2020

Organization subpart

No

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

Authorized official

Name

Oluwole K Adeoye

Title

Owner

Phone

(708) 801-9626

Specialties & licenses 1

Addresses

Other names 1

• Victory Pharmacy Doing business as

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.

• Victory Pharmacy

  • Pharmacy
  • Decatur, IL
  • NPI 1285943829
  NPD tax ID

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

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598659200000",
    "number": "1619580545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 RIVER OAKS DR",
            "city": "CALUMET CITY",
            "state": "IL",
            "postal_code": "604095071",
            "telephone_number": "708-801-9626",
            "fax_number": "708-801-9132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 W 79TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606205720",
            "telephone_number": "773-994-2845",
            "fax_number": "773-482-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY PHARMACY OF DECATUR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-29",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-16",
        "status": "A",
        "authorized_official_last_name": "ADEOYE",
        "authorized_official_first_name": "OLUWOLE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-801-9626"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victory Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victory Centre of Roseland LLC
• Victory Centre of South Chicago LLC
• Victory House
• Victory Medical of Illinois PC
• Victory Medical Supply Inc
• Victory Place
• Victory RX, Inc (Local Health Pharmacy)
• Vida Health Wellness, PLLC
• Vida Medical Centers PLLC
• Vida Pediatrics, LTD.

• Community/Retail Pharmacy in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Retail Pharmacy in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2020; 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.