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
CRAIG S WEINERT (PRESIDENT)
(401) 765-1500
Entity
Organization
Contact information
Practice address
4310 E COTTON CENTER BLVD, STE 110, PHOENIX, AZ 85040-8857
(602) 438-7888
(602) 438-4559
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
—
—
251F00000X
Home Infusion Agency
2749
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
2749
AZ
333600000X
Pharmacy
2749
AZ
3336C0003X
Community/Retail Pharmacy
2749
AZ
3336H0001X
Home Infusion Therapy Pharmacy
Primary
2749
AZ
3336M0002X
Mail Order Pharmacy
2749
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0321579
NCPDP
—
01
—
2749
RX LICENSE
AZ
05
—
328478
—
AZ
Enumeration date
05/05/2006
Last updated
06/23/2025
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