Healthcare Provider Details

I. General information

NPI: 1386674067
Provider Name (Legal Business Name): CORAM ALTERNATE SITE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2345 WATERS DR
MENDOTA HEIGHTS MN
55120-1163
US

IV. Provider business mailing address

PO BOX 646674
CINCINNATI OH
45264-6674
US

V. Phone/Fax

Practice location:
  • Phone: 651-452-5600
  • Fax: 651-452-6510
Mailing address:
  • Phone: 720-895-3211
  • Fax: 303-298-0047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number261268-7
License Number StateMN
# 6
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number261268-7
License Number StateMN
# 7
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number261268-7
License Number StateMN
# 8
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 9
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number261268-7
License Number StateMN
# 10
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number261268-7
License Number StateMN
# 11
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: EMILY FIELD
Title or Position: PRESIDENT
Credential:
Phone: 401-765-1500