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 | 1962436592 |
NPI Entity Type | Organization |
Provider Name |
Coram Healthcare Corporation Of Mississippi
Doing Business As |
Subpart of Organization | Coram Healthcare Corporation Of Mississippi |
Enumeration Date | September 30, 2009 |
Last Update Date | September 30, 2009 |
Certification Date | September 30, 2009 |
Provider Location Address | 2929 Layfair Dr, Suite 100, Flowood, MS, 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. | 03041-02.0 |
License State | MS |
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? |
---|---|---|---|---|---|
No | |||||
No | |||||
03041-02.0 | MS | No | |||
No | |||||
03041-02.0 | MS | No | |||
03041-02.0 | MS | No | |||
03041-02.0 | MS | No | |||
03041-02.0 | MS | No |
Identifier | Identifier State | Identifier Issuer | Type/Code |
---|---|---|---|
BC4376287 | DEA | 01 | |
2517538 | NCPDP | 01 | |
03041-02.0 | MS | RX LICENSE | 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 |
---|---|---|---|
MISS MOT, OTR/L, SCLV Shirley Blanton Individual |
706 Highway 82 W |
||
DO Madison Leigh Lindgren Individual |
2500 N State St |
||
Optimum Occupational Therapy Services, Llc Organization |
706 Highway 82 W |
||
Jacqueline Cartwright Individual |
3171 Quartz Dr |
||
MSN, APRN, FNP-C Felisa Jeannette Hall Individual |
1046 Division St |
||
IDD WAIVER SERVICES Debbie Jones Individual |
405 N First St |
||
IDD WAIVER SERVICES Beverly Johnson Individual |
1406 Mississippi Dr |
||
CRISIS SERVICES Jaricia Kinchen Individual |
934 West Dr |
||
IDD WAIVER SERVICES Monolisa Keyes Individual |
1224 Hillcrest Dr |
||
IDD WAIVER SERVICES Felicia Keller Individual |
405 N First St |
||
IDD WAIVER SERVICES Sharika Jones Individual |
106 Mize St Apt 26 |
||
IDD WAIVER SERVICES Loverta Jones Individual |
5192 Highway 11 N |
||
IDD WAIVER SERVICES Tamekia Mckines Individual |
119 Chambliss Dr |
||
Mary Fowler Individual |
5192 Highway 11 N |
||
IDD WAIVER SERVICES Porosha Gaines Individual |
106 Mize St Apt 26 |
||
DNP, APRN, AGACNP-BC Jo'niece Phillips Redmond Individual |
232 Market St |
||
IDD WAIVER SERVICES Fraxine Graves Individual |
1110 42nd Ave |
||
IDD WAIVER SERVICES Judy Jones Individual |
405 N First St |
||
IDD WAIVER SERVICES Michael Mcdonald Individual |
41 Bonhomie Rd |
||
IDD WAIVER SERVICES Pamela Mcandrews Individual |
106 Mize St Apt 26 |
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