Provider Demographics
NPI:1114302155
Name:VICTORY CYCLE CO. LLC
Entity Type:Organization
Organization Name:VICTORY CYCLE CO. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKOWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-452-9717
Mailing Address - Street 1:301 E MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46901-2359
Mailing Address - Country:US
Mailing Address - Phone:765-452-9717
Mailing Address - Fax:
Practice Address - Street 1:301 E MORGAN ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46901-2359
Practice Address - Country:US
Practice Address - Phone:765-452-9717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-20
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment