Provider Demographics
NPI:1346447240
Name:SOLUBLE SYSTEMS, LLC
Entity Type:Organization
Organization Name:SOLUBLE SYSTEMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:STALEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-635-5400
Mailing Address - Street 1:12050 JEFFERSON AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4385
Mailing Address - Country:US
Mailing Address - Phone:757-635-5400
Mailing Address - Fax:
Practice Address - Street 1:12050 JEFFERSON AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4385
Practice Address - Country:US
Practice Address - Phone:757-635-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6031540001Medicare NSC