Healthcare Provider Details

I. General information

NPI: 1750340428
Provider Name (Legal Business Name): SOLAMOR HOSPICE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 06/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

837 CROCKER RD
WESTLAKE OH
44145-1028
US

IV. Provider business mailing address

837 CROCKER RD
WESTLAKE OH
44145-1028
US

V. Phone/Fax

Practice location:
  • Phone: 440-899-7659
  • Fax: 440-899-9029
Mailing address:
  • Phone: 440-899-7659
  • Fax: 440-899-9029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number0107HSP
License Number StateOH

VIII. Authorized Official

Name: MRS. SHANNAN REZNIK
Title or Position: OFFICE MANAGER
Credential:
Phone: 440-899-7659