Organization
CORAM ALTERNATE SITE SERVICES, INC.
Active
Other names
Coram CVS/ specialty infusion services
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA LACAVICH (PRESIDENT)
(314) 306-3255
Entity
Organization
Contact information
Practice address
4601 E HILTON AVE STE 105, PHOENIX, AZ 85034-6406
(480) 240-3200
Mailing address
PO BOX 809160, CHICAGO, IL 60680-9160
(480) 240-3209
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
Primary
—
—
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Enumeration date
02/21/2018
Last updated
10/20/2022
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