Victory Home Health Agency, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

VICTORY HOME HEALTH AGENCY, INC

Practice address

380 Red Lion Rd Ste 204
Huntingdon Valley, PA 19006-6451

Phone

(267) 342-2453

Fax

(215) 712-8630

NPI assigned

Jul 3, 2019

Organization subpart

No

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

Authorized official

Name

Alexander Kuznetsov

Title

President

Phone

(267) 342-2453

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586304000000",
    "number": "1881256485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 RED LION RD STE 204",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190066451",
            "telephone_number": "267-342-2453",
            "fax_number": "215-712-8630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 RED LION RD STE 204",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190066451",
            "telephone_number": "267-342-2453",
            "fax_number": "215-712-8630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY HOME HEALTH AGENCY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-03",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A",
        "authorized_official_last_name": "KUZNETSOV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "267-342-2453"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1036700040001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Huntingdon Valley, PA
• Providers in Huntingdon Valley, PA by specialty
• Home Health Agency in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.