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General NPI Number Information
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NPI Number | 1902208879
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Entity Type | Organization
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Legal Business Name | CORAM HEALTHCARE CORPORATION OF NORTH TEXAS
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Dates
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Enumeration Date | 09/22/2014
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Last Update Date | 09/22/2014
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Provider Practice Location Address
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Address Line | 6000 BRYANT IRVIN RD
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City | FORT WORTH
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State | TX
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Zip | 76132-4116
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Country | US
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Telephone | 214-902-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 555 17TH ST SUITE 1500
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City | DENVER
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State | CO
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Zip | 80202-3950
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Country | US
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Telephone | 303-672-8631
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Fax |
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Authorized Official
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Title or Position | SR VP, GC, SEC AND DIRECTOR
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Name | MICHAEL E DELL
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Credential |
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Telephone | 303-672-8631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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