Organization
CORAM ALTERNATE SITE SERVICES, INC.
Active
Parent organization
CORAM ALTERNATE SITE SERVICES, INC.
Other names
Coram CVS/specialty Infusion Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORAM ALTERNATE SITE SERVICES, INC.
Authorized official
TRICIA LACAVICH (PRESIDENT)
(314) 306-3255
Entity
Organization
Contact information
Practice address
191 MARGINAL WAY, PORTLAND, ME 04101-3387
(508) 989-9373
Mailing address
PO BOX 809160, CHICAGO, IL 60680-9160
(303) 672-8631
(303) 298-0047
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008717
NCPDP
—
01
—
PH50001464
PHARMACY PERMIT
ME
Enumeration date
12/07/2011
Last updated
03/07/2023
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