MEDICARE: SOLAMOR HOSPICE CORPORATION

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	251G00000X	Community Based Hospice Care Agency	17Q266	CO

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

General Provider Information

NPI Number	:	1326082181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLAMOR HOSPICE CORPORATION

Provider Business Mailing Address
First Line	:	101 SUN AVE NE
Second Line	:	COMPLIANCE DEPARTMENT
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-4373
Country	:	US
Telephone Number	:	505-468-5604
Fax Number	:	505-468-4681

Provider Business Practice Location Address
First Line	:	655 SOUTHPOINTE CT
Second Line	:	SUITE 201
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-3859
Country	:	US
Telephone Number	:	719-226-0091
Fax Number	:	719-226-7900

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GLEN CAVALLO
Credential	:
Telephone Number	:	479-782-9230

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	06/22/2011

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Directions to “SOLAMOR HOSPICE CORPORATION ” Practice Location

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