Organization
CORAM HEALTHCARE OF WYOMING, LLC
Active
Parent organization
CORAM HEALTHCARE OF WYOMING, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORAM HEALTHCARE OF WYOMING, LLC
Authorized official
VITO PONZIO, JR (SR VP)
(303) 672-8631
Entity
Organization
Contact information
Practice address
1507 STILLWATER AVE, SUITE C, CHEYENNE, WY 82009-7358
(307) 635-3785
(307) 635-7002
Mailing address
1675 BROADWAY, SUITE 900, DENVER, CO 80202-4675
(303) 672-8631
(303) 298-0047
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
N/A
WY
Other
Enumeration date
05/29/2006
Last updated
10/08/2007
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