Organization
SOLARA MEDICAL SUPPLIES, LLC
Active
Other names
Imperial Beach Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOD JEFFREY ROBINSON (PRESIDENT)
(858) 259-8287
Entity
Organization
Contact information
Practice address
720 HWY 75, IMPERIAL BEACH, CA 91932
(619) 424-8143
(619) 424-8652
Mailing address
2084 OTAY LAKES RD STE 102, CHULA VISTA, CA 91913-1368
(800) 999-7516
(800) 999-7021
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
PHY46235
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PHA462350
—
CA
Enumeration date
12/12/2005
Last updated
06/19/2018
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