Organization
CORAM ALTERNATE SITE SERVICES, INC.
Active
Organization
CORAM ALTERNATE SITE SERVICES, INC.
Active
Other names
Coram CVS/specialty Infusion Services
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA LACAVICH (PRESIDENT)
(314) 306-3255
Entity
Organization
Contact information
Practice address
2022 GLENN PARK DR, CHAMPAIGN, IL 61821-2405
(217) 356-7900
Mailing address
PO BOX 809160, CHICAGO, IL 60680-9160
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
—
—
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
Other
Enumeration date
02/26/2021
Last updated
10/19/2022
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