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Coram Alternate Site Services, Inc.

Organization Active NPI Home Infusion Agency · Champaign, IL

NPI 1114511490 · NPPES record last updated Oct 19, 2022

Key facts

NPI
1114511490
Entity type
Organization (NPI type 2)
Primary specialty
Home Infusion Agency 251F00000X
Legal business name
CORAM ALTERNATE SITE SERVICES, INC.
Practice address
2022 Glenn Park Dr
Champaign, IL 61821-2405
Phone
(217) 356-7900
NPI assigned
Feb 26, 2021
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 26

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

View all 26

National Provider Directory

Tax ID family
Coram Healthcare (27 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Registered Nurse
Group: 193200000X MULTI-SPECIALTY GROUP		 163WI0500X
Home Health Agency 251E00000X
Home Infusion Agency 251F00000X Yes
Nursing Care Agency 251J00000X

Addresses

Primary practice location

2022 Glenn Park Dr
Champaign, IL 61821-2405

Mailing address

PO Box 809160
Chicago, IL 60680-9160

Other names

  • Coram CVS/specialty Infusion Services Doing business as

Other providers in Champaign, IL

All providers in Champaign, IL · Home Infusion Agency in Illinois

Sources for this page

Verify at the official NPI Registry.