Coram Healthcare Corporation of Greater D.C.

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

CORAM HEALTHCARE CORPORATION OF GREATER D.C.

Practice address

4115 Pleasant Valley Rd Ste 600
Chantilly, VA 20151-1223

Phone

(703) 631-1611

Fax

(703) 631-6738

NPI assigned

Feb 26, 2008

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

CORAM HEALTHCARE CORPORATION OF GREATER D.C.As reported in NPPES

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

Authorized official

Name

Vito Ponzio Jr.

Title

Sr VP and Director

Phone

(303) 672-8631

Specialties & licenses 1

Addresses

Other identifiers 6

Tax ID family

Coram Hlthcare Corp4 organizations share this tax ID, including this one

Part of

Coram Hlthcare Corp

Other organizations with this tax ID 3

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

• Coram Healthcare Corporation of Greater D.C.

  dba Coram CVS/specialty Infusion Services

  • Home Infusion Therapy Pharmacy
  • Denver, CO
  • NPI 1366598575
  NPD tax ID
• Coram Healthcare Corporation of Greater DC

  dba Coram CVS/specialty Infusion Services

  • Infusion Therapy Clinic/Center
  • Hagerstown, MD
  • NPI 1396130381
  NPD tax ID
• Coram Healthcare Corporation of Greater DC

  dba Coram CVS/specialty Infusion Services

  • Infusion Therapy Clinic/Center
  • Silver Spring, MD
  • NPI 1689069676
  NPD tax ID

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

{
    "created_epoch": "1203984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1063681807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 BROADWAY",
            "address_2": "SUITE 900",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802024675",
            "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": "4115 PLEASANT VALLEY RD STE 600",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201511223",
            "telephone_number": "703-631-1611",
            "fax_number": "703-631-6738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAM HEALTHCARE CORPORATION OF GREATER D.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORAM HEALTHCARE CORPORATION OF GREATER D.C.",
        "enumeration_date": "2008-02-26",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "PONZIO",
        "authorized_official_first_name": "VITO",
        "authorized_official_title_or_position": "SR VP AND DIRECTOR",
        "authorized_official_telephone_number": "303-672-8631",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE PHARMACY",
            "identifier": "0201002670",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE",
            "identifier": "465933",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUT OF STATE PHARMACY",
            "identifier": "PO2111",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4829846",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OUT OF STATE PHARMACY",
            "identifier": "MO0559275",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME CARE ORGANIZATION",
            "identifier": "HCO-08176",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Infusion Therapy Clinic/Center in Chantilly, VA
• Providers in Chantilly, VA by specialty
• Infusion Therapy Clinic/Center in Virginia

• 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.