Provider Demographics
NPI:1386020584
Name:VICTORIN, MAGDALINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MAGDALINE
Middle Name:
Last Name:VICTORIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 DAVID COX RD
Mailing Address - Street 2:UNIT 480902
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-2571
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6319 WATERFORD HILLS DR
Practice Address - Street 2:APT 1312
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-3139
Practice Address - Country:US
Practice Address - Phone:980-320-0517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL50549183500000X
NC24975183500000X
FL7580183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist