Organization
CORAM ALTERNATE SITE SERVICES, INC.
Active
Parent organization
CORAM ALTERNATE SITE SERVICES, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORAM ALTERNATE SITE SERVICES, INC.
Authorized official
TRICIA LACAVICH (PRESIDENT)
(314) 306-3255
Entity
Organization
Contact information
Practice address
618 GRASSMERE PARK, SUITE 7, NASHVILLE, TN 37211-3643
(615) 832-9366
(615) 832-9069
Mailing address
PO BOX 809160, CHICAGO, IL 60680-9160
(480) 765-5043
(401) 799-0211
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
0000002879
TN
251F00000X
Home Infusion Agency
0000002879
TN
261QI0500X
Infusion Therapy Clinic/Center
0000002879
TN
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0000002879
TN
333600000X
Pharmacy
0000002879
TN
3336C0003X
Community/Retail Pharmacy
0000002879
TN
3336H0001X
Home Infusion Therapy Pharmacy
Primary
0000002879
TN
3336M0002X
Mail Order Pharmacy
0000002879
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000002879
RX LICENSE
TN
05
—
1452066
—
TN
01
—
4429608
NCPDP
—
05
—
90262890
—
KY
Enumeration date
09/21/2006
Last updated
03/07/2023
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