Victory Medical Supply, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

01915 Issued in MA

Legal business name

VICTORY MEDICAL SUPPLY, INC.

Practice address

100 Cummings Ctr
Suit 135 K
Beverly, MA 01915-6115

Phone

(978) 969-3457

NPI assigned

Jul 12, 2011

Last updated

Jul 12, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Lilian Onoye Ilori

Title

Managing Director

Phone

(978) 969-3457

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310428800000",
    "number": "1932497864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR",
            "address_2": "SUIT 135 K",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156115",
            "telephone_number": "978-969-3457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR",
            "address_2": "SUIT 135 K",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156115",
            "telephone_number": "978-969-3457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-12",
        "last_updated": "2011-07-12",
        "status": "A",
        "authorized_official_last_name": "ILORI",
        "authorized_official_first_name": "LILIAN",
        "authorized_official_middle_name": "ONOYE",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "978-969-3457",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MA",
            "license": "01915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2011; 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.