Organization
CORAM HEALTHCARE CORPORATION OF N Y
Active
Parent organization
CORAM HEALTHCARE CORPORATION OF NEW YORK
Organization subpart
Yes
Provider details
NPI number
Legal business name
CORAM HEALTHCARE CORPORATION OF NEW YORK
Authorized official
MICHAEL DELL (VICE PRESIDENT)
(303) 292-4973
Entity
Organization
Contact information
Practice address
375 N FRENCH RD, SUITE 108, AMHERST, NY 14228-2009
(716) 691-3000
(716) 691-5093
Mailing address
701 TECHNOLOGY DR STE 250, CANONSBURG, PA 15317-9529
(724) 873-7870
(949) 639-6623
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
9694L002
NY
251F00000X
Home Infusion Agency
9694L002
NY
261QI0500X
Infusion Therapy Clinic/Center
9694L002
NY
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
022522
NY
333600000X
Pharmacy
022522
NY
3336C0003X
Community/Retail Pharmacy
022522
NY
3336H0001X
Home Infusion Therapy Pharmacy
Primary
022522
NY
3336M0002X
Mail Order Pharmacy
022522
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3305085
PHARMACY PERMIT
NY
01
—
3305085
NCDPD
—
Enumeration date
08/05/2006
Last updated
03/07/2023
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