Provider Demographics
NPI:1710228085
Name:SOLERA SPECIALTY PHARMACY, LLC
Entity Type:Organization
Organization Name:SOLERA SPECIALTY PHARMACY, LLC
Other - Org Name:SOLERA SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:SARANITI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-615-1840
Mailing Address - Street 1:2100 PARK CENTRAL BLVD N
Mailing Address - Street 2:STE 300
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-2219
Mailing Address - Country:US
Mailing Address - Phone:954-615-1840
Mailing Address - Fax:954-634-3939
Practice Address - Street 1:2100 PARK CENTRAL BLVD N
Practice Address - Street 2:STE 300
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-2219
Practice Address - Country:US
Practice Address - Phone:954-615-1840
Practice Address - Fax:954-634-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN5412OtherTN PHARMACY LICENSE
FLPH26756OtherPHARMACY LICENSE
5715264OtherNCPDP
MSF13416OtherMS PHARMACY LICENSE
FS4010423OtherDEA
FLPH26756OtherPHARMACY LICENSE