Organization
CORAM HEALTHCARE CORPORATION OF GREATER D.C.
Active
Parent organization
CORAM HEALTHCARE CORPORATION OF GREATER D.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORAM HEALTHCARE CORPORATION OF GREATER D.C.
Authorized official
VITO PONZIO JR. (SR VP AND DIRECTOR)
(303) 672-8631
Entity
Organization
Contact information
Practice address
4115 PLEASANT VALLEY RD STE 600, CHANTILLY, VA 20151-1223
(703) 631-1611
(703) 631-6738
Mailing address
1675 BROADWAY, SUITE 900, DENVER, CO 80202-4675
(303) 672-8631
(303) 298-0047
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0201002670
STATE PHARMACY
VA
01
—
465933
CONTROLLED SUBSTANCE
MD
01
—
4829846
NCPDP
—
01
—
HCO-08176
HOME CARE ORGANIZATION
VA
01
—
MO0559275
OUT OF STATE PHARMACY
WV
01
—
PO2111
OUT OF STATE PHARMACY
MD
Enumeration date
02/26/2008
Last updated
03/07/2023
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