Organization
VICTORY MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS VICKY U ANADUMAKA (PRISIDENT)
(773) 783-8666
Entity
Organization
Contact information
Practice address
8156 S COTTAGE GROVE AVE, CHICAGO, IL 60619-5104
(773) 783-8666
(773) 783-8664
Mailing address
8156 S COTTAGE GROVE AVE, CHICAGO, IL 60619-5104
(773) 783-8666
(773) 783-8664
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203000788
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001636799
BC/BS
IL
Enumeration date
02/20/2007
Last updated
03/11/2008
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