Provider Demographics
NPI:1053663906
Name:CORAM ALTERNATE SITE SERVICES, INC.
Entity Type:Organization
Organization Name:CORAM ALTERNATE SITE SERVICES, INC.
Other - Org Name:CORAM CVS/SPECIALTY INFUSION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT,SECRETARY AND DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LACAVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-407-1785
Mailing Address - Street 1:555 17TH ST
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-3950
Mailing Address - Country:US
Mailing Address - Phone:303-672-8631
Mailing Address - Fax:
Practice Address - Street 1:101 EAST SILVER SPRINGS BLVD, SUITE 202
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-6605
Practice Address - Country:US
Practice Address - Phone:904-363-3089
Practice Address - Fax:904-363-2159
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORAM ALTERNATE SITE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-02
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion
No251E00000XAgenciesHome Health