Healthcare Provider Details

I. General information

NPI: 1861005035
Provider Name (Legal Business Name): VICTORY HEALTH CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2020
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E NORTHERN PKWY STE 205207
BALTIMORE MD
21239-2113
US

IV. Provider business mailing address

1900 E NORTHERN PKWY STE 205207
BALTIMORE MD
21239-2113
US

V. Phone/Fax

Practice location:
  • Phone: 443-529-9099
  • Fax:
Mailing address:
  • Phone: 443-529-9099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. BODE AKADRI
Title or Position: CEO
Credential: MPP
Phone: 443-204-5144