Organization
CORAM HEALTHCARE CORPORATION OF GREATER DC
Active
Organization
CORAM HEALTHCARE CORPORATION OF GREATER DC
Active
Parent organization
CORAM HEALTHCARE CORPORATION OF GREATER DC
Other names
Coram CVS/specialty Infusion Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORAM HEALTHCARE CORPORATION OF GREATER DC
Authorized official
TRICIA LACAVICH (PRESIDENT)
(314) 306-3255
Entity
Organization
Contact information
Practice address
7150 COLUMBIA GATEWAY DR, SUITE E, COLUMBIA, MD 21046-2972
(410) 720-6501
(410) 720-6460
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
1094
MD
251F00000X
Home Infusion Agency
Primary
1094
MD
261QI0500X
Infusion Therapy Clinic/Center
1094
MD
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
PWO131
MD
333600000X
Pharmacy
PWO131
MD
3336C0003X
Community/Retail Pharmacy
PWO131
MD
3336H0001X
Home Infusion Therapy Pharmacy
PWO131
MD
3336M0002X
Mail Order Pharmacy
PWO131
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1094
RESIDENTIAL SERVICE AGENC
MD
01
—
2120323
NCPDP
—
01
—
PWO131
RX LICENSE
MD
Enumeration date
07/01/2006
Last updated
03/07/2023
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