Provider Demographics
NPI:1730311465
Name:TOTH ENTERPRISES II
Entity Type:Organization
Organization Name:TOTH ENTERPRISES II
Other - Org Name:VICTORY MEDICAL & FAMILY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOLLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-652-0120
Mailing Address - Street 1:4303 VICTORY DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7507
Mailing Address - Country:US
Mailing Address - Phone:512-462-3627
Mailing Address - Fax:
Practice Address - Street 1:4303 VICTORY DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7507
Practice Address - Country:US
Practice Address - Phone:512-462-3627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-13
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX265813336C0003X
3336C0004X, 3336M0002X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4553423OtherNCPDP PROVIDER IDENTIFICATION NUMBER