EXCELSIOR SPECIALTY PHARMACY INC (NPI# 1114430493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114430493 |
| Entity Type | Organization |
| Organization Name | EXCELSIOR SPECIALTY PHARMACY INC |
| Other Organization Name | EXCELSIOR SPECIALTY PHARMACY INC |
| Practice Address |
3652 Chamblee Dunwoody Rd Ste 3 Atlanta GA 30341-2120 |
| Practice Telephone | 4702228320 |
| Practice Fax Number | 4702228229 |
| Mailing Telephone | 4702228320 |
| Mailing Fax Number | 4702228229 |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2018-04-19 |
| Authorized Official Name | WILLIAM KITSON (OWNER/PIC/AO) |
| Authorized Official Telephone | 6784287325 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PHRE010404 | GA | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2173269 | 01 | |
| GA | 003198495A | 05 |
| Other Name | Type Code |
|---|---|
| EXCELSIOR SPECIALTY PHARMACY INC | Other Name - Individual/Organization |
| Street Address |
3652 CHAMBLEE DUNWOODY RD STE 3 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30341-2120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225388572 | Chamblee Pharmacy Corporation | Pharmacy | 3652 Chamblee Dunwoody Rd Ste 3, Atlanta, GA 30341-2120 | 2012-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992207344 | Rabun Marie Robertson | Occupational Therapist | 2320 Perimeter Park Drive, Atlanta, GA 30341 | 2018-03-01 |
| 1568986313 | Charles Edge IIi | Nurse Practitioner | 4770 Buford Highway, Atlanta, GA 30341 | 2017-08-02 |
| 1366971277 | Park Ridge Healthcare and Physical Medicine LLC | Nurse Practitioner | 2896 Chamblee Tucker Road, Suite 4, Atlanta, GA 30341 | 2017-06-06 |
| 1437502937 | Chara Mcgill | Counselor | 13207 Jefferson Circle N, Chamblee, GA 30341 | 2016-07-20 |
| 1982063913 | Stepping Stone of Atlanta | Community/Behavioral Health | 3705 Chamblee Dunwoody Rd, Chamblee, GA 30341 | 2016-02-18 |
| 1013317577 | Marne Day | Counselor | 3720 Chamblee Dunwoody Rd, Chamblee, GA 30341 | 2014-09-02 |
| 1013343680 | Keelan Walker | Speech-Language Pathologist | 4961 Buford Highway Suite 201, Suite 201, Chamblee, GA 30341 | 2013-09-16 |
| 1578901955 | Promonitor LLC | Electrodiagnostic Medicine | 3300 Northwest Expy Bldg 7, Atlanta, GA 30341 | 2013-06-07 |
| 1639415359 | Lawanda B Cooke | Health Educator | 5280 Peachtree Ind Blvd, Chamblee, GA 30341 | 2012-12-28 |
| 1457602773 | Arthur Macrae Wendel | Family Medicine | 4770 Buford Hwy Ms F60, Atlanta, GA 30341 | 2012-09-26 |
| Find all providers in zip 30341 | ||||
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817208 | Mlk Pharmacy2.0 | Pharmacy | 2457 Mlk Jr Dr Sw Ste A, Atlanta, GA 30311-1712 | 2020-10-01 |
| 1407492119 | Capsule Atlanta LLC | Pharmacy | 867 Peachtree St Ne Ste 102, Atlanta, GA 30308-1380 | 2019-11-18 |
| 1861978793 | Uhs of Peachford Lp | Pharmacy | 2150 Peachford Rd Ste D, Atlanta, GA 30338 | 2018-07-13 |
| 1497262778 | Champions Pharmacy | Pharmacy | 3886 Princeton Lakes Way Suite 180, Atlanta, GA 30331 | 2018-01-08 |
| 1912357641 | Headland Pharmacy LLC | Pharmacy | 2973 Headland Drive, Suite B, Atlanta, GA 30331 | 2016-06-14 |
| 1285022277 | Express Food & Pharmacy Investment LLC | Pharmacy | 2111 Campbellton Rd Sw, Atlanta, GA 30311-4605 | 2014-12-30 |
| 1881024479 | Camp Creek Village Pharmacy Inc. | Pharmacy | 3220 Butner Rd Sw Suite #130, Atlanta, GA 30331 | 2013-11-18 |
| 1487093662 | Pharm Holdings | Pharmacy | 102 E Allday St, Atlanta, TX 75551-2305 | 2013-06-20 |
| 1255676326 | Eastlake Pharmacy Inc | Pharmacy | 1308 Glenwood Ave Se, Atlanta, GA 30316-2077 | 2012-11-30 |
| 1689918468 | Wal-mart Stores East Lp | Pharmacy | 835 Martin Luther King Jr Dr Nw, Atlanta, GA 30314-3644 | 2012-11-19 |
| Find all providers in ATLANTA | ||||
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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.