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General NPI Number Information
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NPI Number | 1619082641
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Entity Type | Organization
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Legal Business Name | EXCEL PHARMACY LLC
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 17731 E WARREN AVE
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City | DETROIT
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State | MI
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Zip | 48224-1329
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Country | US
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Telephone | 313-308-4500
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Fax | 866-299-8907
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Provider Business Mailing Address
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Address Line | 17731 E WARREN AVE
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City | DETROIT
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State | MI
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Zip | 48224-1329
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Country | US
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Telephone | 313-308-4500
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Fax | 866-299-8907
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Authorized Official
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Title or Position | OWNER AND PHARMACIST
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Name | EDDY AOUN
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Credential | PHARMD
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Telephone | 313-308-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301008452
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License Number State | MI
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