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NPI Code Detail

MEDICARE: CORAM ALTERNATE SITE SERVICES, INC.

MEDICARE: CORAM ALTERNATE SITE SERVICES, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251F00000XHome Infusion Agency
2251E00000XHome Health Agency

General Provider Information

NPI Number : 1861760233
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORAM ALTERNATE SITE SERVICES, INC.
Provider Business Mailing Address
First Line : PO BOX 809160
Second Line :
City : CHICAGO
State : IL
Zip : 60680-9160
Country : US
Telephone Number : 480-765-5043
Fax Number :
Provider Business Practice Location Address
First Line : 555 WINDERLEY PL STE 300
Second Line :
City : MAITLAND
State : FL
Zip : 32751-7133
Country : US
Telephone Number : 407-571-6834
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : TRICIA LACAVICH
Credential :
Telephone Number : 314-306-3255
Provider Enumeration Date : 12/13/2011
Last Update Date : 10/21/2022

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Directions to “CORAM ALTERNATE SITE SERVICES, INC. ” Practice Location

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