VICTORY PHARMACY OF DECATUR INC (NPI# 1619580545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619580545 |
| Entity Type | Organization |
| Organization Name | VICTORY PHARMACY OF DECATUR INC |
| Practice Address |
2024 W 79th St Chicago IL 60620-5720 |
| Mailing Address |
1837 River Oaks Dr Calumet City IL 60409-5071 |
| Practice Telephone | 7739942845 |
| Practice Fax Number | 7734822008 |
| Mailing Telephone | 7088019626 |
| Mailing Fax Number | 7088019132 |
| Enumeration Date | 2020-08-29 |
| Last Update Date | 2020-08-29 |
| Authorized Official Name | OLUWOLE K ADEOYE (OWNER) |
| Authorized Official Telephone | 7088019626 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| Victory Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689159832 | Victory Pharmacy of Decatur Inc | Pharmacy | 1837 River Oaks Rd, Calumet City, IL 60409 | 2018-10-03 |
| Street Address |
2024 W 79TH ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60620-5720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184886517 | Gregg Martin Delossantos | Podiatrist | 2024 W 79th St, Chicago, IL 60620-5720 | 2008-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295358182 | Kenya Reed | Developmental Therapist | 8920 S Loomis St, Apt 116, Chicago, IL 60620 | 2020-05-26 |
| 1255820031 | Bnd Transportation | Non-emergency Medical Transport (VAN) | 9436 S Laflin St # 3, Chicago, IL 60620 | 2018-05-07 |
| 1386132520 | It Takes A Community LLC | Day Training, Developmentally Disabled Services | 9046 S Justine St, Chicago, IL 60620 | 2018-04-24 |
| 1598200164 | Julie Rae Scott | Social Worker | 400 W 76th Street, Suite 226, Chicago, IL 60620 | 2017-01-05 |
| 1033521968 | James Towns | Clinical Exercise Physiologist | 9247 S. Wentworth, Chicago, IL 60620 | 2014-05-27 |
| 1629488788 | Renee Victoria Green | Counselor | 9415 S. Lowe, Chicago, IL 60620 | 2014-04-29 |
| 1588085138 | Steven Hsu | Chiropractor | 9415 S. Western Ave., Suite 207, Chicago, IL 60620 | 2013-12-30 |
| 1164791810 | Richard Kasper | Pharmacist | 7901 S Western, Chicago, IL 60620 | 2011-12-27 |
| 1992089916 | Michawn Willis | Pharmacist | 8636 S Ashland, Chicago, IL 60620 | 2011-10-10 |
| 1770884314 | Gjm Consultant Services PC | Home Health | 400 W. 76th Street, Suite 202, Chicago, IL 60620 | 2010-11-13 |
| Find all providers in zip 60620 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
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| 1952909632 | Cordant Pharmacy Illinois, LLC | Pharmacy | 8623 W Bryn Mawr Ave Ste 504, Chicago, IL 60631-3525 | 2020-10-14 |
| 1891308045 | Apotheco Pharmacy Lincoln Park LLC | Pharmacy | 2140 N Halsted St, Chicago, IL 60614-4385 | 2020-08-27 |
| 1558994921 | Diaz Holdings, Inc. | Pharmacy | 3204 W Lawrence Ave, Chicago, IL 60625-5209 | 2020-02-13 |
| 1427698349 | Heena Vital Rx, Inc. | Pharmacy | 1525 E 55th St Ste 103, Chicago, IL 60615-5514 | 2020-01-08 |
| 1952944563 | Ameer Pharmacy Inc. | Pharmacy | 104 W 111th St, Chicago, IL 60628-4215 | 2019-10-26 |
| 1255981106 | Elsdon Pharmacy, Inc. | Pharmacy | 4254 W 55th St Ste 100, Chicago, IL 60632-4642 | 2019-09-12 |
| 1346702669 | Cardinal Health 132 LLC | Pharmacy | 641 W 63rd St Ste 100, Chicago, IL 60621-2032 | 2019-04-04 |
| 1245703982 | Luna Pharmacy At Madison LLC | Pharmacy | 3171 W Madison St Ste 2, Chicago, IL 60612-1809 | 2019-01-04 |
| 1427534742 | Genoa Healthcare, LLC | Pharmacy | 4318 S State St Ste 26, Chicago, IL 60609-3701 | 2018-07-19 |
| 1356843072 | Advanced Care Rx LLC | Pharmacy | 11422 S Western Ave Ste 101, Chicago, IL 60643-4120 | 2018-03-08 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.