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Organization
VICTORY MEDICAL SUPPLY
Active
Organization
VICTORY MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR MOYOSORE OLAOFE (CEO)
(818) 997-6968
Entity
Organization
Contact information
Practice address
6411 SEPULVEDA BLVD, STE 1J, VAN NUYS, CA 91411-1304
(818) 997-6968
(818) 997-6946
Mailing address
6411 SEPULVEDA BLVD, STE 1J, VAN NUYS, CA 91411-1304
(818) 997-6968
(818) 997-6946
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
46843
CA
Other
Enumeration date
03/14/2007
Last updated
11/21/2007
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