Organization
CORAM HEALTHCARE CORPORATION OF KENTUCKY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VITO PONZIO JR. (SR VP)
(303) 672-8631
Entity
Organization
Contact information
Practice address
4305 MULHAUSER RD, SUITE 1, FAIRFIELD, OH 45014-2263
(513) 874-1161
(513) 874-8774
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
720060
KY
251F00000X
Home Infusion Agency
Primary
720060
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
720060
MOBILE HEALTH PERMIT
KY
Enumeration date
08/13/2006
Last updated
09/11/2025
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