Provider Demographics
NPI:1649849373
Name:E&G EXCEL CORP
Entity type:Organization
Organization Name:E&G EXCEL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GERMAN
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:JAIME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-572-6901
Mailing Address - Street 1:2701 WILLIAMSBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-4109
Mailing Address - Country:US
Mailing Address - Phone:929-371-3185
Mailing Address - Fax:
Practice Address - Street 1:2701 WILLIAMSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-4109
Practice Address - Country:US
Practice Address - Phone:929-371-3185
Practice Address - Fax:917-933-8885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-17
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY038896OtherPHARMACY RESGISTRATION NUMBER