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
TRICIA LACAVICH (PRESIDENT)
(314) 306-3255
Entity
Organization
Contact information
Practice address
1500 WYNKOOP ST, DENVER, CO 80202-1150
(303) 799-0093
(303) 790-0633
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
—
—
251F00000X
Home Infusion Agency
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
370000024
CO
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
370000024
CO
333600000X
Pharmacy
370000024
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03002565
—
CO
01
—
0614380
NCPDP
—
01
—
370000024
RX LICENSE
CO
Enumeration date
07/25/2006
Last updated
03/07/2023
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