Provider Demographics
NPI:1174869937
Name:VICTORIA Z ENTERPRISES, LLC
Entity type:Organization
Organization Name:VICTORIA Z ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:Z
Authorized Official - Last Name:FERRO
Authorized Official - Suffix:
Authorized Official - Credentials:CFM
Authorized Official - Phone:509-324-8612
Mailing Address - Street 1:3131 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-1900
Mailing Address - Country:US
Mailing Address - Phone:509-324-8612
Mailing Address - Fax:509-324-0357
Practice Address - Street 1:3131 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1900
Practice Address - Country:US
Practice Address - Phone:509-324-8612
Practice Address - Fax:509-324-0357
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603 257 524335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier