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Contact Information

VICTORY DISTRIBUTORS LLC
79 BICENTENNIAL DR
MANCHESTER, NH03104
 Phone: 603-644-2204
 Fax: 603-666-0600
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for VICTORY DISTRIBUTORS LLC

NPI # 1578671822
LBN Legal business name VICTORY DISTRIBUTORS LLC
Authorized official MICHAEL VAIL - (PRESIDENT AND MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/28/2006
Last updated 04/20/2018 - About 8 years ago
Identifiers
NH License # 0336
NH Medicaid 30004278
NH Medicaid 3080809
Other 2053025 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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