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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

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1299991256OTHERFLHOME HEALTH AGENCY

General Provider Information

NPI Number : 1306085964
Entity Type Code : Organization
Provider Name (Legal Business Name) : CORAM ALTERNATE SITE SERVICES, INC.
Provider Business Mailing Address
First Line : 555 17TH ST
Second Line : SUITE 1500
City : DENVER
State : CO
Zip : 80202-3950
Country : US
Telephone Number : 303-672-8631
Fax Number : 303-298-0047
Provider Business Practice Location Address
First Line : 9310 SOUTHPARK CENTER LOOP
Second Line : SUITE 101
City : ORLANDO
State : FL
Zip : 32819-8634
Country : US
Telephone Number : 407-571-6834
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : TRICIA L LACAVICH
Credential :
Telephone Number : 318-407-1785
Provider Enumeration Date : 02/05/2009
Last Update Date : 10/20/2022

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

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