Coram Alternate Site Services Inc, NPI 1912953431
Home Infusion Therapy Pharmacy in Boise, ID, US

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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
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Organization Official

Official Name Tricia Lacavich
Official Position PRESIDENT
Phone 314-306-3255

Primary Taxonomy

Taxonomy Code

3336H0001X

Taxonomy Name Home Infusion Therapy Pharmacy
Classification

Pharmacy

Group

Suppliers

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.

Other Organization Name

Coram CVS/specialty Infusion Services
Doing Business As

Business Address

Coram Alternate Site Services Inc
11660 W Executive Dr

Boise, ID, US

Phone: 208-323-0303
Fax: 208-323-0381

Mailing Address

Coram Alternate Site Services Inc
Po Box 809160
Chicago, IL, US
ZIP 606809160
Phone: 866-224-5134
Fax: 303-298-0047

Secondary Taxonomies

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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