Victory Family Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

17031602 Issued in NY

Legal business name

VICTORY FAMILY PHARMACY, LLC

Doing business as

The Apothecary Shoppe

Practice address

1975 Victory Blvd Ste a
Staten Island, NY 10314-3536

Phone

(718) 448-0400

Fax

(718) 448-0404

NPI assigned

Oct 2, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Alex Antonopoulos, PHARMD

Title

Pharmacist / Managing Member

Phone

(718) 448-0400

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Apothecary Shoppe Doing business as

Locations

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1912258807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1975 VICTORY BLVD STE A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143536",
            "telephone_number": "718-448-0400",
            "fax_number": "718-448-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 VICTORY BLVD STE A",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143536",
            "telephone_number": "718-448-0400",
            "fax_number": "718-448-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY FAMILY PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-02",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "ANTONOPOULOS",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "PHARMACIST / MANAGING MEMBER",
        "authorized_official_telephone_number": "718-448-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "17031602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "17 031602",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Apothecary Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Victory Ambulatroy Services, LLC
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• Victory Blvd Medical Procedures PC
• Victory Blvd Social Day Care Inc
• Victory Dental PLLC
• Victory Internal Medicine, P.C.
• Victory Medical Group PLLC
• Victory Medical PLLC
• Victory Medical PLLC
• Victory Medical Services PLLC

• Community/Retail Pharmacy in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.