Provider Demographics
NPI:1902466105
Name:SOLARIS PHARMACY 2
Entity Type:Organization
Organization Name:SOLARIS PHARMACY 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-627-1011
Mailing Address - Street 1:2511 CROCKETT DRIVE
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801
Mailing Address - Country:US
Mailing Address - Phone:940-207-1638
Mailing Address - Fax:844-826-6885
Practice Address - Street 1:2511 CROCKETT DRIVE
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801
Practice Address - Country:US
Practice Address - Phone:940-207-1638
Practice Address - Fax:844-826-6885
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOLARIS PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-19
Last Update Date:2024-03-20
Deactivation Date:2024-01-19
Deactivation Code:
Reactivation Date:2024-03-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32697OtherTEXAS STATE BOARD OF PHARMACY