Organization
CORAM HEALTHCARE CORPORATION OF NORTHERN CALIFORNIA
Active
Organization
CORAM HEALTHCARE CORPORATION OF NORTHERN CALIFORNIA
Active
Parent organization
CORAM HEALTHCARE CORP OF NORTHERN CALIFORNIA
Other names
Coram CVS/specialty Infusion Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORAM HEALTHCARE CORP OF NORTHERN CALIFORNIA
Authorized official
TRICIA LACAVICH (PRESIDENT)
(314) 306-3255
Entity
Organization
Contact information
Practice address
1401 WILLOW PASS RD, CONCORD, CA 94520-7982
(323) 371-5046
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
020000338
CA
251F00000X
Home Infusion Agency
Primary
020000338
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020000338
HOME HEALTH AGENCY
CA
01
—
0522385
NCPDP
—
05
—
PHA466360
—
CA
01
—
PHY49294
PHARMACY LICENSE
CA
Enumeration date
05/06/2006
Last updated
03/07/2023
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