Coram Alternate Site Services Inc, NPI 1912953431
Home Infusion Therapy Pharmacy in Boise, ID, US
NPI number: what is it?
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 | 1912953431 |
| 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 | 11660 W Executive Dr, Boise, ID, US |
| Provider Mailing Address | Po Box 809160, Chicago, IL, US, 606809160 |
| Gender | Male |
| Is Sole Proprietor? | No |
Organization Official
| Official Name | Tricia Lacavich |
| Official Position | PRESIDENT |
| Phone | 314-306-3255 |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Home Infusion Therapy Pharmacy |
| Classification | |
| Group | |
| License No. | 1014PA-PS |
| License State | ID |
| 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. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| No | |||||
| No | |||||
| N/A | ID | No | |||
| No | |||||
| 1014PA-PS | ID | No | |||
| 1014PA-PS | ID | No | |||
| 1014PA-PS | ID | No | |||
| 1677LS | ID | No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 1014PA-PS | ID | RX LICENSE | 01 |
| 1305906 | NCPDP | 01 | |
| BC4565567 | DEA | 01 | |
| 1677LS | ID | RX LICENSE | 01 |
| 0021815 | ID | MEDICAID | 05 |
| 0028527 | ID | MEDICAID | 05 |
| 231894 | OR | MEDICAID | 05 |
| 298495 | OR | MEDICAID | 05 |
Health Information Exchange
| 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 |
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