Organization
CORAM ALTERNATE SITE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG S WEINERT (PRESIDENT)
(401) 765-1500
Entity
Organization
Contact information
Practice address
10915 TECHNOLOGY PL, SAN DIEGO, CA 92127-1811
(858) 637-6314
(858) 637-6394
Mailing address
1675 BROADWAY, SUITE 900, DENVER, CO 80202-4675
(303) 672-8631
(303) 298-0047
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
101225
CA
332BC3200X
Customized Equipment (DME)
101225
CA
332BX2000X
Oxygen Equipment & Supplies (DME)
101225
CA
3336C0003X
Community/Retail Pharmacy
48353
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45674
MEDICAL DEVICE RETAILER
CA
01
—
48353
PHARMACY LICENSE
CA
Enumeration date
10/06/2006
Last updated
03/12/2024
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