Healthcare Provider Details

I. General information

NPI: 1811182132
Provider Name (Legal Business Name): VICTORY MEDICAL EQUIPMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 10/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8209 HWY 277 STE C VICTORY MEDICAL EQUIPMENT LLC
ELGIN OK
73538
US

IV. Provider business mailing address

P.O. BOX 769 VICTORY MEDICAL EQUIPMENT 8209 HWY 277 STE C
ELGIN OK
73538
US

V. Phone/Fax

Practice location:
  • Phone: 580-492-4079
  • Fax: 580-492-6160
Mailing address:
  • Phone: 580-492-4079
  • Fax: 580-492-6160

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. KEVIN MORGAN
Title or Position: SUPERVISOR
Credential:
Phone: 580-371-0340