Healthcare Provider Details

I. General information

NPI: 1316981178
Provider Name (Legal Business Name): SOLAMOR HOSPICE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 06/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7950 E PRENTICE AVE SUITE 101
GREENWOOD VILLAGE CO
80111-2722
US

IV. Provider business mailing address

101 SUN AVE NE COMPLIANCE DEPARTMENT
ALBUQUERQUE NM
87109-4373
US

V. Phone/Fax

Practice location:
  • Phone: 720-200-1036
  • Fax: 720-200-4514
Mailing address:
  • Phone: 505-468-5604
  • Fax: 505-468-4681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number0937
License Number StateCO

VIII. Authorized Official

Name: GLEN CAVALLO
Title or Position: PRESIDENT DIRECTOR
Credential:
Phone: 479-782-9230