Excel Specialty Pharmacy LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EXCEL SPECIALTY PHARMACY LLC

Doing business as

Excel Specialty Pharmacy

Practice address

604 N Magnolia Ave Ste 105
Clovis, CA 93611-9205

Phone

(302) 229-5481

NPI assigned

Jun 15, 2019

Last updated

Sep 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Adeola O EdemaNPI 1710262407

Title

Manager

Phone

(559) 375-1241

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• EXCEL SPECIALTY PHARMACY Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adeola Edema

  • Pharmacist
  • Clovis, CA
  • NPI 1710262407
  NPD Authorized official

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

{
    "created_epoch": "1560556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1932769684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3338 DUNCAN AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936195007",
            "telephone_number": "559-375-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N MAGNOLIA AVE STE 105",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936119205",
            "telephone_number": "302-229-5481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEL SPECIALTY PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-15",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "EDEMA",
        "authorized_official_first_name": "ADEOLA",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "559-375-1241",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932769684",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.exlrx.com",
            "affiliation": "Y",
            "endpointDescription": "website",
            "affiliationName": "NextGen Health LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "604 N Magnolia Ave Ste 105",
            "city": "Clovis",
            "state": "CA",
            "country_code": "US",
            "postal_code": "936119205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "EXCEL SPECIALTY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Clovis, CA
• Providers in Clovis, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.