# EXCELSIOR SPECIALTY PHARMACY INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** EXCELSIOR SPECIALTY PHARMACY INC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114430493
- **Authorized official:** WILLIAM KITSON (OWNER/PIC/AO)
- **Authorized official phone:** (678) 428-7325

## Contact information

- **Practice address:** 3652 CHAMBLEE DUNWOODY RD STE 3, ATLANTA, GA 30341-2120
- **Practice address phone:** (470) 222-8320
- **Practice address fax:** (470) 222-8229
- **Mailing address:** 3652 CHAMBLEE DUNWOODY RD STE 3, ATLANTA, GA 30341-2120
- **Mailing address phone:** (470) 222-8320
- **Mailing address fax:** (470) 222-8229

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHRE010404 | GA | Yes |

## Other

- **Enumeration date:** 11/09/2017
- **Last updated:** 04/19/2018