Basic Information
| Provider Information | |||||||||
| NPI: | 1992887327 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EXCELLA DME, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 HAVERHILL RD | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | AMESBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019132123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783884500 | ||||||||
| FaxNumber: | 9783888255 | ||||||||
| Practice Location | |||||||||
| Address1: | 110 HAVERHILL RD | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | AMESBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019132123 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783884500 | ||||||||
| FaxNumber: | 9783888255 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GOODE | ||||||||
| AuthorizedOfficialFirstName: | BRIAN | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9783884500 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.