Provider Demographics
NPI:1073752309
Name:SOLID ROCK ENTERPRISES, INC.
Entity Type:Organization
Organization Name:SOLID ROCK ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:S
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-384-2064
Mailing Address - Street 1:428 W RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-6103
Mailing Address - Country:US
Mailing Address - Phone:540-384-2064
Mailing Address - Fax:540-384-2065
Practice Address - Street 1:428 W RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-6103
Practice Address - Country:US
Practice Address - Phone:540-384-2064
Practice Address - Fax:540-384-2065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2705 112890A332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment