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NPI Code Detail

MEDICARE: SOLAMOR HOSPICE CORPORATION

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
1251G00000XCommunity Based Hospice Care Agency4160OK

General Provider Information

NPI Number : 1780626218
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 : 1900 NW EXPRESSWAY
Second Line : SUITE 320
City : OKLAHOMA CITY
State : OK
Zip : 73118-1802
Country : US
Telephone Number : 405-842-0171
Fax Number : 405-842-8511
Authorized Official
Title or Position : PRESIDENT
Name : GLEN CAVALLO
Credential :
Telephone Number : 479-782-9230
Provider Enumeration Date : 06/11/2006
Last Update Date : 06/21/2011

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Directions to “SOLAMOR HOSPICE CORPORATION ” Practice Location

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