MEDICARE: SOLVENCY HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336M0002X	Mail Order Pharmacy
3	3336S0011X	Specialty Pharmacy
4	3336C0003X	Community/Retail Pharmacy	PP482558	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2152377	OTHER		PK

General Provider Information

NPI Number	:	1104206382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLVENCY HEALTH LLC

Provider Business Mailing Address
First Line	:	7 BALA AVE STE 100
Second Line	:
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-3205
Country	:	US
Telephone Number	:	610-713-5661
Fax Number	:	610-713-5720

Provider Business Practice Location Address
First Line	:	7 BALA AVE STE 100
Second Line	:
City	:	BALA CYNWYD
State	:	PA
Zip	:	19004-3205
Country	:	US
Telephone Number	:	610-713-5661
Fax Number	:	610-713-5720

Authorized Official
Title or Position	:	PRESIDENT
Name	:	IGDALIAH JACKSON
Credential	:
Telephone Number	:	610-333-0131

Provider Enumeration Date	:	06/03/2015
Last Update Date	:	09/19/2025

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Directions to “SOLVENCY HEALTH LLC ” Practice Location

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