NPIMap

Organization Active NPI

Coram Healthcare Corporation of Greater DC

Doing business as Coram CVS/specialty Infusion Services

  • Home Infusion Agency
  • Falls Church, VA
National Provider Identifier
1134228745
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion AgencyTaxonomy code 251F00000X
License
HCO-176 Issued in VA
Legal business name
CORAM HEALTHCARE CORPORATION OF GREATER DC
Doing business as
Coram CVS/specialty Infusion Services
Practice address
3190 Fairview Park Dr
Falls Church, VA 22042-4530
Phone
(443) 669-8675
Fax
(703) 631-6738
NPI assigned
Sep 21, 2006
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

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
President
Phone
(314) 306-3255

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HCO-176 VA
Home Infusion Agency 251F00000X HCO-176 VA Primary

Addresses

Primary practice location

3190 Fairview Park Dr
Falls Church, VA 22042-4530

Mailing address

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

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 Corp O

Member of 2

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

Locations

3190 Fairview Park Dr
Falls Church, VA 22042
Phone (443) 669-8675

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1134228745",
    "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": "3190 FAIRVIEW PARK DR",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220424530",
            "telephone_number": "443-669-8675",
            "fax_number": "703-631-6738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAM HEALTHCARE CORPORATION OF GREATER DC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORAM HEALTHCARE CORPORATION OF GREATER D.C.",
        "enumeration_date": "2006-09-21",
        "last_updated": "2023-03-07",
        "certification_date": "2022-12-16",
        "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": "VA",
            "license": "HCO-176",
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "VA",
            "license": "HCO-176",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Falls Church, VA

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.