Provider Demographics
NPI:1699581462
Name:VICTORY PHARMACY LLC
Entity type:Organization
Organization Name:VICTORY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:BARINAADAA
Authorized Official - Last Name:KEKII
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-276-4506
Mailing Address - Street 1:6306 LOGAN CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3616
Mailing Address - Country:US
Mailing Address - Phone:314-276-4506
Mailing Address - Fax:281-497-3225
Practice Address - Street 1:23869 WEST STATE HWY 6
Practice Address - Street 2:SUITE A
Practice Address - City:ALVIN
Practice Address - State:TX
Practice Address - Zip Code:77511
Practice Address - Country:US
Practice Address - Phone:314-276-4506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy