Organization
SOLARUS MEDICAL ENTERPRISES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LEE ELDER (AUTHORIZED OFFICIAL)
(214) 762-7468
Entity
Organization
Contact information
Practice address
12127 BLUE RIDGE EXT STE A, GRANDVIEW, MO 64030-1106
(888) 994-6688
(888) 405-5893
Mailing address
10347 CROSS CREEK BLVD, SUITE H, TAMPA, FL 33647-2993
(816) 746-1901
(888) 405-5893
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
NOT APPLICABLE
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932354883
UNICARE MEDICAID
KS
01
—
1932354883
HUMANA
MO
05
—
1932354883
—
IA
05
—
1932354883
—
MO
05
—
200589760A
—
KS
01
—
42107013
BLUE CROSS BLUE SHIELD OF KANSAS CITY
MO
Enumeration date
11/19/2008
Last updated
02/26/2020
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