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Organization

CORAM HEALTHCARE CORPORATION OF GREATER DC

Active
Parent organization
CORAM HEALTHCARE CORPORATION OF GREATER D.C.
Other names
Coram CVS/specialty Infusion Services
Organization subpart
Yes

Provider details

NPI number
Legal business name
CORAM HEALTHCARE CORPORATION OF GREATER D.C.
Authorized official
TRICIA LACAVICH (PRESIDENT)
(314) 306-3255
Entity
Organization

Contact information

Practice address
3190 FAIRVIEW PARK DR, FALLS CHURCH, VA 22042-4530
(443) 669-8675
(703) 631-6738
Mailing address
PO BOX 809160, CHICAGO, IL 60680-9160
(480) 765-5043
(401) 733-0211

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
HCO-176
VA
251F00000X
Home Infusion Agency
Primary
HCO-176
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0201002670
RX LICENSE
VA
01
4829846
NCPDP
Enumeration date
09/21/2006
Last updated
03/07/2023
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