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General NPI Number Information
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NPI Number | 1356716534
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Entity Type | Organization
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Legal Business Name | SOLARA MEDICAL SUPPLIES, LLC
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Dates
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Enumeration Date | 12/14/2015
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 2084 OTAY LAKES RD STE 102
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City | CHULA VISTA
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State | CA
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Zip | 91913-1368
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Country | US
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Telephone | 619-600-3276
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Fax | 619-600-3273
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Provider Business Mailing Address
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Address Line | 555 E NORTH LN STE 5075
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City | CONSHOHOCKEN
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State | PA
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Zip | 19428-2490
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CCO
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Name | WENDY RUSSALESI
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Credential |
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Telephone | 484-246-9499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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