Solara Medical Supplies, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

PHY46235 Issued in CA

Legal business name

SOLARA MEDICAL SUPPLIES, LLC

Doing business as

Imperial Beach Pharmacy

Practice address

720 Hwy 75
Imperial Beach, CA 91932

Phone

(619) 424-8143

Fax

(619) 424-8652

NPI assigned

Dec 12, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Tod Jeffrey Robinson

Title

President

Phone

(858) 259-8287

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Imperial Beach Pharmacy Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529366400000",
    "number": "1154306231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2084 OTAY LAKES RD STE 102",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131368",
            "telephone_number": "800-999-7516",
            "fax_number": "800-999-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 HWY 75",
            "city": "IMPERIAL BEACH",
            "state": "CA",
            "postal_code": "91932",
            "telephone_number": "619-424-8143",
            "fax_number": "619-424-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLARA MEDICAL SUPPLIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-12",
        "last_updated": "2018-06-19",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "TOD",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-259-8287",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "CA",
            "license": "PHY46235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA462350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imperial Beach Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Imperial Beach Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Imperial Beach, CA
• Providers in Imperial Beach, CA by specialty
• Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.