Provider Demographics
NPI:1962830448
Name:EXCEL RX INC
Entity type:Organization
Organization Name:EXCEL RX INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASLI
Authorized Official - Middle Name:
Authorized Official - Last Name:PERAINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-313-0100
Mailing Address - Street 1:5272 FRANCIS ST
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710
Mailing Address - Country:US
Mailing Address - Phone:909-313-0100
Mailing Address - Fax:888-255-7004
Practice Address - Street 1:5272 FRANCIS ST
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710
Practice Address - Country:US
Practice Address - Phone:909-313-0100
Practice Address - Fax:888-255-7004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-21
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPHY 546103336C0003X
CAPHY 516343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPHY 54610OtherSTATE BOARD OF PHARMACY PERMIT
CA56-49148OtherNCPDP