NPI | 1114430493 |
---|---|
Other Name | EXCELSIOR SPECIALTY PHARMACY INC |
Entity Type | Organization |
Authorized Contact | WILLIAM KITSON Owner/PIC/AO 678-428-7325 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: GA PHRE010404) |
Additional Taxonomies | 333600000X Pharmacy |
Enumeration Date | 2017-11-09 |
Last Update Date | 2018-04-19 |