Solamor Hospice Lafayette

LBN: Countryside Hospice Care Inc
Solamor Hospice Lafayette is an health care organization with primary practice located at 106 Pearl Dr Suite 107, La Fayette GA 30728-7509. The organization recently has only one registered license in Agencies / Hospice Care, Community Based, which is considered as the primary health care specialty. Countryside Hospice Care Inc can be contacted via phone (706) 638-7651, or through Cavallo, Glen via phone (479) 996-5900.

Contact Information

Primary practice address
106 Pearl Dr Suite 107 La Fayette GA 30728-7509
Phone: (706) 638-7651
Fax: (706) 638-7545
Website:
Map and Directions
Authorized official contact:
Name: Cavallo, Glen
Phone: (479) 996-5900

Health care specialties

SpecialtyCodeLicense #State
Agencies / Hospice Care, Community Based 251G00000X 146142H Georgia

Profile Details

NPI number 1265470249
LBN Legal business name Countryside Hospice Care Inc
DBA Doing business as Solamor Hospice Lafayette
Authorized official Cavallo, Glen
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 3rd, 2006
Last updated Feb 16th, 2012 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265470249 NPPES
Georgia MEDICAID 00850044A
Georgia Other 146142H

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