Organization
CORAM HEALTHCARE CORPORATION OF SOUTH CAROLINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VITO PONZIO JR. (SR VP)
(303) 672-8631
Entity
Organization
Contact information
Practice address
1941 SAVAGE RD, SUITE 500AA, CHARLESTON, SC 29407-4704
(843) 769-5544
(843) 769-4300
Mailing address
1675 BROADWAY, SUITE 900, DENVER, CO 80202-4675
(303) 672-8631
(303) 298-0047
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
50-003160
SC
333600000X
Pharmacy
Primary
50-003160
SC
3336C0003X
Community/Retail Pharmacy
50-003160
SC
3336H0001X
Home Infusion Therapy Pharmacy
50-003160
SC
3336M0002X
Mail Order Pharmacy
50-003160
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4219350
NCPDP
—
01
—
50-003160
RX LICENSE
SC
05
—
731608
—
SC
05
—
DME151
—
SC
Enumeration date
08/13/2006
Last updated
09/11/2025
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