Provider Demographics
NPI:1285397026
Name:EXELA PHARMACY, INC.
Entity type:Organization
Organization Name:EXELA PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HUYQUANG
Authorized Official - Middle Name:CHI
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:916-256-3788
Mailing Address - Street 1:6039 GREENBACK LN
Mailing Address - Street 2:
Mailing Address - City:CITRUS HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:95621-4740
Mailing Address - Country:US
Mailing Address - Phone:916-256-3788
Mailing Address - Fax:916-256-3723
Practice Address - Street 1:6039 GREENBACK LN
Practice Address - Street 2:
Practice Address - City:CITRUS HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:95621-4740
Practice Address - Country:US
Practice Address - Phone:916-256-3788
Practice Address - Fax:916-256-3723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy