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CORAM ALTERNATE SITE SERVICES INC NPI 1790734036


NPI Information

NPI: 1790734036
Provider Name: CORAM ALTERNATE SITE SERVICES INC

Doing Business As: CORAM CVS/SPECIALTY INFUSION SERVICES

Classification: Pharmacy - 3336H0001X
Entity Type: Organization

Specialization: Home Infusion Therapy Pharmacy

Address:
12310 WORLD TRADE DR
SUITE 100
SAN DIEGO, CA
ZIP 92128
Phone: (858) 576-6969
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CORAM ALTERNATE SITE SERVICES INC is a home infusion therapy pharmacy pharmacy in San Diego, CA. The provider is 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. CORAM ALTERNATE SITE SERVICES INC NPI is 1790734036. The provider is registered as an organization entity type.
The provider Is Doing Business As Coram Cvs/specialty Infusion Services.

The provider's business location address is:

12310 WORLD TRADE DR
SUITE 100
SAN DIEGO, CA
ZIP 92128-793
Phone: (858) 576-6969
Fax: (858) 974-6606

The provider's authorized official is Tricia Lacavich .
The authorized official title is President and has the following contact phone number (314) 306-3255.

The enumeration date for this NPI number is 5/5/2006 and was last updated on 3/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome Health0800429CALIFORNIANo
2251F00000XHome Infusion0800429CALIFORNIANo
3261QI0500XClinic/CenterInfusion TherapyCALIFORNIANo
4332B00000XDurable Medical Equipment & Medical SuppliesPHY50273CALIFORNIANo
5332BP3500XDurable Medical Equipment & Medical SuppliesParenteral & Enteral NutritionPHY50273CALIFORNIANo
6333600000XPharmacyPHY50273CALIFORNIANo
73336C0003XPharmacyCommunity/Retail PharmacyPHY50273CALIFORNIANo
83336C0004XPharmacyCompounding PharmacyPHY50273CALIFORNIANo
93336M0002XPharmacyMail Order PharmacyPHY50273CALIFORNIANo
103336S0011XPharmacySpecialty PharmacyPHY50273CALIFORNIANo
113336H0001XPharmacyHome Infusion Therapy PharmacyPHY50273CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10522311OTHERNCPDP
2PHA409320MEDICAIDCALIFORNIA
3101225OTHERCALIFORNIAMEDICAL DEVICE RETAILER
40800429OTHERCALIFORNIAHOME HEALTH AGENCY
5PHY50273OTHERCALIFORNIAPHARMACY LICES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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