Provider Demographics
NPI:1407684079
Name:VICTORY HEARING CARE
Entity type:Organization
Organization Name:VICTORY HEARING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-207-7350
Mailing Address - Street 1:3441 NOVUM RD
Mailing Address - Street 2:
Mailing Address - City:REVA
Mailing Address - State:VA
Mailing Address - Zip Code:22735-1742
Mailing Address - Country:US
Mailing Address - Phone:540-207-7350
Mailing Address - Fax:
Practice Address - Street 1:568 WATERLOO RD STE 103
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186-3090
Practice Address - Country:US
Practice Address - Phone:540-513-9897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment