Provider Demographics
NPI:1609193192
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 DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:ELDER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:813-994-6688
Mailing Address - Street 1:10347 CROSS CREEK BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2993
Mailing Address - Country:US
Mailing Address - Phone:888-994-6688
Mailing Address - Fax:866-342-9716
Practice Address - Street 1:4109 CITY POINT DR STE E
Practice Address - Street 2:
Practice Address - City:RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8339
Practice Address - Country:US
Practice Address - Phone:888-994-6688
Practice Address - Fax:866-342-9716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-23
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNOT APPLICABLE332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217910303Medicaid
TXNAOtherBLUE CROSS BLUE SHIELD OF TX
TXNAOtherHEALTHSMART
TXNAOtherASSURANT HEALTH PLAN
TXN/AOtherRIGHT CARE - SCOTT & WHITE HEALTH PLAN
TXNAOtherTRICARE
TXNAOtherPARKLAND COMMUNITY HEALTH PLAN
TXNAOtherGREAT-WEST HEALTHCARE
TXNAOtherFIRSTCARE HEALTH PLANS
TXNAOtherMOLINA OF TX
TXNAOtherMULTI PLAN
TXNAOtherHUMANA
TXNAOtherUNICARE
TXNAOtherPRIME HEALTH
TXNAOtherSUPERIOR HEALTH PLAN
TXNAOtherUNIVERSAL HEALTHCARE
TXN/AOtherCOOK CHILDREN'S HEALTH PLAN
TXNAOtherUNITED HEALTHCARE
TXNAOtherUMR
TXNAOtherPHCS
TXN/AOtherFIRST HEALTH
TXNAOtherBEECH STREET
TXNAOtherCIGNA
TXNAOtherUNICARE
TXNAOtherTRICARE