Organization
VICTORY DISTRIBUTORS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL VAIL (PRESIDENT AND MANAGER)
(207) 885-7454
Entity
Organization
Contact information
Practice address
201 JOHN DEVINE DR, MANCHESTER, NH 03103
(603) 626-1233
(603) 626-3002
Mailing address
PO BOX 1000, MS 3000, PORTLAND, ME 04104-5005
(207) 885-7454
(704) 645-6531
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
0366
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2053050
PK
—
05
—
30005022
—
NH
05
—
3080814
—
NH
Enumeration date
08/27/2006
Last updated
04/20/2018
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