NPIMap

Organization Active NPI

Coram Alternate Site Services, Inc.

  • Home Infusion Therapy Pharmacy
  • Dunbar, WV
National Provider Identifier
1366499881
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
Legal business name
CORAM ALTERNATE SITE SERVICES, INC.
Practice address
206 Roxalana Business Park
Dunbar, WV 25064-2727
Phone
(304) 768-1241
Fax
(304) 768-0925
NPI assigned
May 29, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Organization subpart
No

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
(318) 407-1785

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Home Infusion Agency 251F00000X
Infusion Therapy Clinic/Center 261QI0500X N/A WV
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X SP0552256 WV
Pharmacy 333600000X SP0552256 WV
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X SP0552256 WV
Home Infusion Therapy Pharmacy 3336H0001X SP0552256 WV
Home Infusion Therapy Pharmacy 3336H0001X Primary
Mail Order Pharmacy 3336M0002X SP0552256 WV

Addresses

Primary practice location

206 Roxalana Business Park
Dunbar, WV 25064-2727

Mailing address

1675 Broadway
Suite 900
Denver, CO 80202-4675
Phone (303) 672-8631

Other identifiers 5

IdentifierTypeStateIssuer
90009721MedicaidKY
5403328700MedicaidKY
8508001MedicaidWV
5010486OtherNCPDP
SP0552256OtherWVRX LICENSE

National Provider Directory

National Provider Directory
Tax ID family
Curaflex Infusion SVC27 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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1148860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1366499881",
    "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": "206 ROXALANA BUSINESS PARK",
            "city": "DUNBAR",
            "state": "WV",
            "postal_code": "250642727",
            "telephone_number": "304-768-1241",
            "fax_number": "304-768-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAM ALTERNATE SITE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-29",
        "last_updated": "2023-03-07",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "LACAVICH",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-407-1785"
    },
    "taxonomies": [
        {
            "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": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "WV",
            "license": "N/A",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "WV",
            "license": "SP0552256",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WV",
            "license": "SP0552256",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WV",
            "license": "SP0552256",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "WV",
            "license": "SP0552256",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "WV",
            "license": "SP0552256",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90009721",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5403328700",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8508001",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5010486",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RX LICENSE",
            "identifier": "SP0552256",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunbar, WV

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.