The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
NPI | 1437161999 |
NPI Entity Type | Organization |
Provider Name |
Coram Alternate Site Services Inc
Doing Business As |
Subpart of Organization | Coram Alternate Site Services Inc |
Enumeration Date | September 30, 2009 |
Last Update Date | September 30, 2009 |
Certification Date | September 30, 2009 |
Provider Location Address | 9143 Philips Hwy, Suite 300, Jacksonville, FL, US |
Provider Mailing Address | Po Box 809160, Chicago, IL, US, 606809160 |
Gender | Male |
Is Sole Proprietor? | No |
Official Name | Tricia Lacavich |
Official Position | PRESIDENT |
Phone | 314-306-3255 |
Taxonomy Code | |
Taxonomy Name | Home Infusion Therapy Pharmacy |
Classification | |
Group | |
License No. | PH13472 |
License State | FL |
Description | Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance. |
Taxonomy Code | Group | Classification | License No. | State | Primary? |
---|---|---|---|---|---|
HHA20222096 | FL | No | |||
HHA20222096 | FL | No | |||
HHA20222096 | FL | No | |||
No | |||||
PH13472 | FL | No | |||
PH13472 | FL | No | |||
PH13472 | FL | No | |||
PH13472 | FL | No | |||
PH13472 | FL | No |
Identifier | Identifier State | Identifier Issuer | Type/Code |
---|---|---|---|
105458901 | FL | MEDICAID | 05 |
BC4512059 | DEA | 01 | |
1076149 | NCPDP | 01 | |
PH13472 | FL | RX LICENSE | 01 |
105458900 | FL | MEDICAID | 05 |
HHA20222096 | FL | HOME HEALTH AGENCY | 01 |
Endpoint Type | Endpoint | Description | Use | Content Type | Affiliation | Location |
---|---|---|---|---|---|---|
CONNECT | https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service | 2.16.840.1.113883.3.667.2 | OTHER | Yes | 100 N 6th St Ste 900A, Minneapolis, MN, US |
NPI | Name | Taxonomy | Address |
---|---|---|---|
Sonia Bach Peguero Individual |
2411 Nw 10th Ave Apt 103 |
||
Adriana Sivilla Individual |
7390 Sw 107th Ave Apt 307 |
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APRN Yudelsy Sanchez Morell Individual |
8180 Mandarin Blvd |
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5656 W 25th Ct |
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23624 Sw 115th Ct |
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3674 Honey Dew Ln |
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7108 S Kanner Hwy |
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106 W Windhorst Rd |
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1 Alhambra Plz Ph Floor |
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DR. M.D. Kimberley Kleckner Individual |
14470 Harlee Rd |
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2220 E Irlo Bronson Memorial Hwy |
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We Beehave, Inc. Organization |
770 Se Indian St Ste 17 |
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MR. LMT Michell Pavoni Individual |
2301 Coral Way Ste 815 |
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APRN Kelsey Barton Friedman Individual |
4866 Big Island Dr Unit 5 |
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Hana Ann Steingold Individual |
644 Ferguson Dr Ste 200 |
||
PHARMD Susmita Jasmine Samuel Individual |
9005 Us Highway 301 N |
||
MS. ARNP Sylwia Anna Cyrwus Individual |
13670 Walsingham Rd |
||
MD Tiffani Mathew Individual |
12902 Usf Magnolia Dr |
||
MR. MAT, ATC Robert Michael Shifrin Individual |
3031 Garrison Rd |
||
OTR/L Raquel Ioia Individual |
3898 Via Poinciana Ste 17 |
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