Provider Demographics
NPI:1558781005
Name:SOLI S PHARMACY INC
Entity Type:Organization
Organization Name:SOLI S PHARMACY INC
Other - Org Name:CARLSBAD VILLAGE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PIC
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MORISOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-729-2405
Mailing Address - Street 1:1005 CARLSBAD VILLAGE DR STE D2
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1883
Mailing Address - Country:US
Mailing Address - Phone:760-729-2405
Mailing Address - Fax:760-729-1340
Practice Address - Street 1:1005 CARLSBAD VILLAGE DR STE D2
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1883
Practice Address - Country:US
Practice Address - Phone:760-729-2405
Practice Address - Fax:760-729-1340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-23
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
CAPHY518673336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2145483OtherPK
CA1558781005Medicaid