Provider Demographics
NPI:1902369879
Name:SOLACE CARE LLC
Entity Type:Organization
Organization Name:SOLACE CARE LLC
Other - Org Name:CASTLE WINTON PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE/PHARMACY OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PRATAP
Authorized Official - Middle Name:KRISHNA
Authorized Official - Last Name:ANNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-635-5260
Mailing Address - Street 1:6029 N WINTON WAY STE A
Mailing Address - Street 2:
Mailing Address - City:WINTON
Mailing Address - State:CA
Mailing Address - Zip Code:95388-9515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6029 N WINTON WAY STE A
Practice Address - Street 2:
Practice Address - City:WINTON
Practice Address - State:CA
Practice Address - Zip Code:95388-9515
Practice Address - Country:US
Practice Address - Phone:209-635-5260
Practice Address - Fax:209-635-5117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA57561OtherPHARMACY LICENSE
CA57561OtherPHARMACY LICENSE