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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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