Provider Demographics
NPI:1427395474
Name:EXCELLE CARE LLC
Entity Type:Organization
Organization Name:EXCELLE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DERRICK
Authorized Official - Middle Name:E
Authorized Official - Last Name:GALMORE
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:267-819-6979
Mailing Address - Street 1:2646 S DAGGETT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-2805
Mailing Address - Country:US
Mailing Address - Phone:267-819-6979
Mailing Address - Fax:
Practice Address - Street 1:2646 S DAGGETT ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-2805
Practice Address - Country:US
Practice Address - Phone:267-819-6979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA21353601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health