Provider Demographics
NPI:1235456724
Name:SOLARUS ENTERPRISES, LLC
Entity Type:Organization
Organization Name:SOLARUS ENTERPRISES, LLC
Other - Org Name:SOLARUS MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CO-OWNER
Authorized Official - Phone:813-994-6688
Mailing Address - Street 1:10006 CROSS CREEK BLVD
Mailing Address - Street 2:PMB 450
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2595
Mailing Address - Country:US
Mailing Address - Phone:888-994-6688
Mailing Address - Fax:866-570-7457
Practice Address - Street 1:10347 CROSS CREEK BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2993
Practice Address - Country:US
Practice Address - Phone:888-994-6688
Practice Address - Fax:866-570-7457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MANOT APPLICABLE332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies