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Organization

CORAM HEALTHCARE CORPORATION OF NEW YORK

Active
Parent organization
CORAM HEALTHCARE CORPORATION OF NEW YORK
Organization subpart
Yes

Provider details

NPI number
Legal business name
CORAM HEALTHCARE CORPORATION OF NEW YORK
Authorized official
VITO PONZIO JR. (SR VP)
(303) 672-8631
Entity
Organization

Contact information

Practice address
12 JUPITER LN, ALBANY, NY 12205-6918
(518) 689-2900
(518) 689-2900
Mailing address
1675 BROADWAY, SUITE 900, DENVER, CO 80202-4675
(303) 672-8631
(303) 298-0047

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
9694L001
NY
251F00000X
Home Infusion Agency
9694L001
NY
261QI0500X
Infusion Therapy Clinic/Center
9694L001
NY
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
022519
NY
333600000X
Pharmacy
022519
NY
3336C0003X
Community/Retail Pharmacy
022519
NY
3336H0001X
Home Infusion Therapy Pharmacy
Primary
022519
NY
3336M0002X
Mail Order Pharmacy
022519
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01573555
NY
01
022519
RX LICENSE
NY
01
3305047
NCPDP
01
9694L001
HOME HEALTH AGENCY
NY
Enumeration date
08/13/2006
Last updated
03/07/2023
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