NPI 1639117690 · live from the CMS NPI Registry
Countryside Hospice Care INC
Hospice Care, Community Based in Sharpsburg, GA. National Provider Identifier 1639117690, active.
NPI record
| NPI | 1639117690 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Hospice Care, Community Based 251G00000X |
| Practice location | 820 Ebenezer Church Rd, Suite 106, Sharpsburg, GA 30277 |
| Practice phone | 770-252-4999 |
| Mailing address | 101 Sun Ave Ne, Albuquerque, NM 87109 |
| Enumerated | June 3, 2006 |
| Last updated | February 16, 2012 |
| Authorized official | Glen Cavallo, Sr. Vp - Operations |
| Other names | Solamor Hospice Sharpsburg |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Hospice Care, Community Based primary | 251G00000X | 038156H (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.