NPIMap

Organization Active NPI

Coram Healthcare Corporation of Southern Florida

Doing business as Coram CVS/specialty Infusion Services

  • Home Infusion Agency
  • Plantation, FL
National Provider Identifier
1053365544
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
License
HHA20290096 Issued in FL
Legal business name
CORAM HEALTHCARE CORPORATION OF SOUTHERN FLORIDA
Doing business as
Coram CVS/specialty Infusion Services
Practice address
261 N University Dr
Plantation, FL 33324-2002
Phone
(954) 829-4490
NPI assigned
May 20, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CORAM HEALTHCARE CORPORATION OF SOUTHERN FLORIDAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tricia Lacavich
Title
Presadent
Phone
(314) 306-3255

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU
Home Infusion Agency 251F00000X HHA20290096 FL Primary
Home Infusion Therapy Pharmacy 3336H0001X PH23578 FL

Addresses

Primary practice location

261 N University Dr
Plantation, FL 33324-2002

Mailing address

PO Box 809160
Chicago, IL 60680-9160
Phone (480) 765-5043

Other identifiers 2

IdentifierTypeStateIssuer
PH23578OtherFLPHARMACY PERMIT
HHA20290096OtherFLHOME HEALTH AGENCY

Other names 1

  • Coram CVS/specialty Infusion Services Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

National Provider Directory

National Provider Directory
Part of
Coram Healthcare of So

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 305

Organizations listed as members of this organization in the National Provider Directory.

View all 305

Locations

12006 Miramar Pkwy
Miramar, FL 33025
Phone (954) 431-3335

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1053365544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 809160",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606809160",
            "telephone_number": "480-765-5043",
            "fax_number": "401-733-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 N UNIVERSITY DR",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242002",
            "telephone_number": "954-829-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAM HEALTHCARE CORPORATION OF SOUTHERN FLORIDA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORAM HEALTHCARE CORPORATION OF SOUTHERN FLORIDA",
        "enumeration_date": "2006-05-20",
        "last_updated": "2023-03-07",
        "certification_date": "2022-12-29",
        "status": "A",
        "authorized_official_last_name": "LACAVICH",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "PRESADENT",
        "authorized_official_telephone_number": "314-306-3255"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "FL",
            "license": "HHA20290096",
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "FL",
            "license": "PH23578",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY PERMIT",
            "identifier": "PH23578",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH AGENCY",
            "identifier": "HHA20290096",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Coram CVS/specialty Infusion Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coram CVS/specialty Infusion Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.