NPIMap

Organization Active NPI

Coram Alternate Site Services, Inc.

Doing business as Coram CVS/specialty Infusion Services

  • Home Infusion Agency
  • Champaign, IL
National Provider Identifier
1114511490
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
Legal business name
CORAM ALTERNATE SITE SERVICES, INC.
Doing business as
Coram CVS/specialty Infusion Services
Practice address
2022 Glenn Park Dr
Champaign, IL 61821-2405
Phone
(217) 356-7900
NPI assigned
Feb 26, 2021
Last updated
Oct 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WI0500X
Home Health Agency 251E00000X
Home Infusion Agency 251F00000X Primary
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 1

  • Coram CVS/specialty Infusion Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Coram Alternat Site SVC Inc27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666137600000",
    "number": "1114511490",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 GLENN PARK DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618212405",
            "telephone_number": "217-356-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAM ALTERNATE SITE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-26",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "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": "163WI0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.