| 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 |