Provider Demographics
NPI:1609615210
Name:SOLVERA HEALTHCARE CENTER INC
Entity type:Organization
Organization Name:SOLVERA HEALTHCARE CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-886-9172
Mailing Address - Street 1:PO BOX 9727
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61612-9727
Mailing Address - Country:US
Mailing Address - Phone:309-886-9172
Mailing Address - Fax:
Practice Address - Street 1:256 S SOANGETAHA RD STE 108
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-5596
Practice Address - Country:US
Practice Address - Phone:309-233-2836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOLVERA HEALTHCARE CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-22
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy