Provider Demographics
NPI:1639364953
Name:VICTORY MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:VICTORY MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-371-0340
Mailing Address - Street 1:1323 S. BROADWAY
Mailing Address - Street 2:VICTORY MEDICAL EQUIPMENT LLC
Mailing Address - City:MARLOW
Mailing Address - State:OK
Mailing Address - Zip Code:73055
Mailing Address - Country:US
Mailing Address - Phone:580-658-7041
Mailing Address - Fax:580-658-7097
Practice Address - Street 1:1323 S. BROADWAY
Practice Address - Street 2:VICTORY MEDICAL EQUIPMENT LLC
Practice Address - City:MARLOW
Practice Address - State:OK
Practice Address - Zip Code:73055
Practice Address - Country:US
Practice Address - Phone:580-658-7041
Practice Address - Fax:580-658-7097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies