Provider Demographics
NPI:1295142347
Name:SOLIANT HEALTH
Entity type:Organization
Organization Name:SOLIANT HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR ACCOUNT EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:KINCEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-947-8233
Mailing Address - Street 1:5946 GREEN POND DRIVE
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258
Mailing Address - Country:US
Mailing Address - Phone:904-886-2071
Mailing Address - Fax:
Practice Address - Street 1:5946 GREEN POND DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-1143
Practice Address - Country:US
Practice Address - Phone:904-886-2071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051038125333600000X
FLPS39603333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy