NPIMap

Organization Active NPI

Coram Healthcare Corporation of Greater New York

Doing business as Coram CVS/specialty Infusion Services

  • Home Infusion Agency
  • Long Island, NY
National Provider Identifier
1063424216
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
License
9073L002 Issued in NY
Legal business name
CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK
Doing business as
Coram CVS/specialty Infusion Services
Practice address
28-07 Jackson Avenue
Long Island, NY 11101-1110
Phone
(516) 491-7930
Fax
(718) 730-9398
NPI assigned
Aug 13, 2006
Last updated
Jan 30, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
CORAM HEALTHCARE CORPORATION OF GREATER NEW YORKAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 9073L002 NY
Home Infusion Agency 251F00000X 9073L002 NY Primary

Addresses

Primary practice location

28-07 Jackson Avenue
Long Island, NY 11101-1110

Mailing address

PO Box 809160
Chicago, IL 60680-9160
Phone (303) 672-8631

Other identifiers 1

IdentifierTypeStateIssuer
9073L002OtherNYHOME HEALTH AGENCY

Other names 1

  • Coram CVS/specialty Infusion Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New York Home Therapy5 organizations share this tax ID, including this one
Part of
New York Home Therapy

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9777 Queens Blvd
Ste 1100
Rego Park, NY 11374

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1063424216",
    "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": "303-672-8631",
            "fax_number": "303-298-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28-07 JACKSON AVENUE",
            "city": "LONG ISLAND",
            "state": "NY",
            "postal_code": "111011110",
            "telephone_number": "516-491-7930",
            "fax_number": "718-730-9398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK",
        "enumeration_date": "2006-08-13",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "LACAVICH",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-306-3255"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NY",
            "license": "9073L002",
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "NY",
            "license": "9073L002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH AGENCY",
            "identifier": "9073L002",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "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 Long Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.