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CORAM HEALTHCARE CORPORATION OF SOUTHERN CALIFORNIA NPI 1740239623


NPI Information

NPI: 1740239623
Provider Name: CORAM HEALTHCARE CORPORATION OF SOUTHERN CALIFORNIA

Doing Business As: CORAM CVS/SPECIALTY INFUSION SERVICES

Classification: Pharmacy - 3336H0001X
Entity Type: Organization

Specialization: Home Infusion Therapy Pharmacy

CLIA Number: 05D0913814

Address:
4355 E LOWELL ST
STE C
ONTARIO, CA
ZIP 91761
Phone: (909) 605-0010
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CORAM HEALTHCARE CORPORATION OF SOUTHERN CALIFORNIA is a home infusion therapy pharmacy pharmacy in Ontario, 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 HEALTHCARE CORPORATION OF SOUTHERN CALIFORNIA NPI is 1740239623. 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:

4355 E LOWELL ST
STE C
ONTARIO, CA
ZIP 91761-225
Phone: (909) 605-0010
Fax: (906) 605-5771

The provider's authorized official is Jody L Kepler .
The authorized official title is President and has the following contact phone number (303) 292-4973.

The CLIA number assigned to this NPI record is 05D0913814 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/9/2006 and was last updated on 3/24/2016.


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 Health2400748CALIFORNIANo
2251F00000XHome Infusion2400748CALIFORNIANo
3261QI0500XClinic/CenterInfusion TherapyCALIFORNIANo
4332B00000XDurable Medical Equipment & Medical SuppliesPHY49297CALIFORNIANo
5332BP3500XDurable Medical Equipment & Medical SuppliesParenteral & Enteral NutritionPHY 40884CALIFORNIANo
6333600000XPharmacyPHY 40884CALIFORNIANo
73336C0003XPharmacyCommunity/Retail PharmacyPHY 40884CALIFORNIANo
83336M0002XPharmacyMail Order PharmacyPHY 40884CALIFORNIANo
93336H0001XPharmacyHome Infusion Therapy PharmacyPHY 40884CALIFORNIAYes

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
1BC4508579OTHERDEA
20563500003MEDICARE NSCCALIFORNIA
3PHA 408840MEDICAIDCALIFORNIA
40553708OTHERNCPDP
52400748OTHERCALIFORNIAHOME HEALTH AGENCY
6PHY49297OTHERCALIFORNIAPHARMACY LICENSE

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: 11/14/2023

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.