| Victorybridge Healthcare, Llc | |
|
1720 E 32nd St Silver City NM 88061-8304 | |
| (202) 413-2078 | |
| Not Available |
| Full Name | Victorybridge Healthcare, Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1720 E 32nd St, Silver City, New Mexico |
| Authorized Official Name and Position | Victoria Agbonma Odocha (DIRECTOR) |
| Authorized Official Contact | 2024132078 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Victorybridge Healthcare, Llc 1914 Rosebay Ct Sugar Land TX 77479-4037 Ph: (202) 413-2078 | Victorybridge Healthcare, Llc 1720 E 32nd St Silver City NM 88061-8304 Ph: (202) 413-2078 |
| NPI Number | 1043091853 |
|---|---|
| Provider Enumeration Date | 10/09/2023 |
| Last Update Date | 03/16/2025 |
| Certification Date | 03/16/2025 |
| Medicare PECOS PAC ID | 4789105610 |
|---|---|
| Medicare Enrollment ID | O20250307003483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043091853 | NPI | - | NPPES |
| Provider Name | Victoria Agbonma Odocha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316635626 PECOS PAC ID: 5395094171 Enrollment ID: I20240607002262 |
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