Organization
CORAM ALTERNATE SITE SERVICES INC
Active
Parent organization
CORAM ALTERNATE SITE SERVICES INC
Other names
Coram CVS/specialty Infusion Services
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
180 PASSAIC AVE, FAIRFIELD, NJ 07004-3516
(973) 756-5963
Mailing address
PO BOX 809160, CHICAGO, IL 60680-9160
(303) 672-8631
(303) 298-0047
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HP0218401
NJ
251F00000X
Home Infusion Agency
Primary
HP0218401
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28RS00527400
RX LICENSE
NJ
01
—
3137064
NCPDP
—
Enumeration date
07/20/2006
Last updated
03/07/2023
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