Provider Demographics
NPI:1972048247
Name:SOLUTIA MEDICAL LLC
Entity Type:Organization
Organization Name:SOLUTIA MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ALSUP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-299-3930
Mailing Address - Street 1:10759 INDIAN HEAD INDUSTRIAL BLVD.
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132
Mailing Address - Country:US
Mailing Address - Phone:888-670-4452
Mailing Address - Fax:
Practice Address - Street 1:335 LEFFINGWELL AVE
Practice Address - Street 2:SUITE126
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-6417
Practice Address - Country:US
Practice Address - Phone:314-299-3930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-22
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies