Provider Demographics
NPI:1972541449
Name:EXCEL HEALTH CARE, INC.
Entity type:Organization
Organization Name:EXCEL HEALTH CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SR VP, SECRETARY & GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:BONACCORSI
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:847-229-7794
Mailing Address - Street 1:1910 PAYSPHERE CIR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-0019
Mailing Address - Country:US
Mailing Address - Phone:800-879-6137
Mailing Address - Fax:847-913-9024
Practice Address - Street 1:4170 LAFAYETTE CENTER DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-1254
Practice Address - Country:US
Practice Address - Phone:703-471-8200
Practice Address - Fax:703-471-8205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0201003388261QI0500X, 332BP3500X, 3336H0001X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8508879Medicaid
VA9114637Medicaid
VA9114637Medicaid