Excel Pharmacy Partners LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PH31118 Issued in FL

Legal business name

EXCEL PHARMACY PARTNERS LLC

Doing business as

Stat Pharmacy

Practice address

6817 Southpoint Pkwy Ste 2204
Jacksonville, FL 32216-8200

Phone

(904) 800-2285

Fax

(904) 813-7905

NPI assigned

Jan 10, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marc Eisenmann

Title

Manager

Phone

(201) 344-3691

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Stat Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Excel Pharmacy Partners LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Excel Pharmacy Partners LLC

  • Specialty Pharmacy
  • Jacksonville, FL
  • NPI 1598474017
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Roy Principe

  • Pharmacist
  • Orange Park, FL
  • NPI 1760762215
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669161600000",
    "number": "1841707940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 SW 57TH PL",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333126369",
            "telephone_number": "201-344-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6817 SOUTHPOINT PKWY STE 2204",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168200",
            "telephone_number": "904-800-2285",
            "fax_number": "904-813-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL PHARMACY PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-10",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A",
        "authorized_official_last_name": "EISENMANN",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "201-344-3691"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH31118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102482400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY LICENSE #",
            "identifier": "PH31118",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stat Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Excellsior Home Health LLC
• Excelsior Community Services, LLC
• Excelsior Diagnostics LLC
• Exceptional Comfort and Care, LLC
• Exceptional Wellness of Florida Incorporated

• Community/Retail Pharmacy in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.