Organization
VICTORY MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSE IDIONG (OWNER/MANAGER)
(248) 552-8533
Entity
Organization
Contact information
Practice address
29350 SOUTHFIELD RD, STE 121, SOUTHFIELD, MI 48076-2053
(248) 552-8533
(248) 552-7281
Mailing address
29350 SOUTHFIELD RD, STE 121, SOUTHFIELD, MI 48076-2053
(248) 552-8533
(248) 552-7281
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4509852
—
MI
Enumeration date
08/13/2006
Last updated
08/22/2020
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