Provider Demographics
NPI:1255703567
Name:EXCEL PHARMACY
Entity type:Organization
Organization Name:EXCEL PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ALEMAYEHU
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-652-1776
Mailing Address - Street 1:3923 S CAPITOL ST SW UNIT A
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2308
Mailing Address - Country:US
Mailing Address - Phone:202-652-1776
Mailing Address - Fax:202-652-1951
Practice Address - Street 1:3923 S CAPITOL ST SW UNIT A
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2308
Practice Address - Country:US
Practice Address - Phone:202-652-1776
Practice Address - Fax:202-652-1951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRX00000973336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy