Provider Demographics
NPI:1285659300
Name:SOLIS HEALTHCARE, LP
Entity Type:Organization
Organization Name:SOLIS HEALTHCARE, LP
Other - Org Name:ROXBOROUGH MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CHIEF EXECUTIVE OFFIC
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DONNELLY
Authorized Official - Suffix:JR
Authorized Official - Credentials:CPA
Authorized Official - Phone:215-487-4245
Mailing Address - Street 1:5800 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-1737
Mailing Address - Country:US
Mailing Address - Phone:215-487-4245
Mailing Address - Fax:215-487-4274
Practice Address - Street 1:5800 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-1737
Practice Address - Country:US
Practice Address - Phone:215-487-4245
Practice Address - Fax:215-487-4274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA910401273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA39-T304Medicare PIN