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
8370 WOLF LAKE DR STE 107, BARTLETT, TN 38133-7108
(615) 630-9279
Mailing address
PO BOX 809160, CHICAGO, IL 60680-9160
(303) 672-8631
(303) 298-0047
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000002058
RX LICENSE
TN
01
—
4429420
NCPDP
—
Enumeration date
08/21/2006
Last updated
03/07/2023
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