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CORAM ALTERNATE SITE SERVICES INC NPI 1912953431


NPI Information

NPI: 1912953431
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

CLIA Number: 13D0989080

Address:
11660 W EXECUTIVE DR
BOISE, ID
ZIP 83713
Phone: (208) 323-0303
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CORAM ALTERNATE SITE SERVICES INC is a home infusion therapy pharmacy pharmacy in Boise, ID. 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 1912953431. 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:

11660 W EXECUTIVE DR
BOISE, ID
ZIP 83713-996
Phone: (208) 323-0303
Fax: (208) 323-0381

The provider's authorized official is Craig S Weinert .
The authorized official title is President and has the following contact phone number (401) 765-1500.

The CLIA number assigned to this NPI record is 13D0989080 - home health agency with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/26/2006 and was last updated on 3/9/2024.


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 HealthNo
2251F00000XHome InfusionNo
3261QI0500XClinic/CenterInfusion TherapyN/AIDAHONo
4332B00000XDurable Medical Equipment & Medical SuppliesNo
5332BP3500XDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition1014PA-PSIDAHONo
6333600000XPharmacy1014PA-PSIDAHONo
73336C0003XPharmacyCommunity/Retail Pharmacy1014PA-PSIDAHONo
83336H0001XPharmacyHome Infusion Therapy Pharmacy1014PA-PSIDAHOYes
93336M0002XPharmacyMail Order Pharmacy1677LSIDAHONo

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
10021815MEDICAIDIDAHO
20028527MEDICAIDIDAHO
31677LSOTHERIDAHORX LICENSE
4231894MEDICAIDOREGON
51014PA-PSOTHERIDAHORX LICENSE
61305906OTHERNCPDP
7298495MEDICAIDOREGON

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.