NPIMap

Organization Active NPI

Coram Alternate Site Services Inc

  • Home Infusion Therapy Pharmacy
  • Mendota Heights, MN
National Provider Identifier
1386674067
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Infusion Therapy PharmacyTaxonomy code 3336H0001X
License
261268-7 Issued in MN
Legal business name
CORAM ALTERNATE SITE SERVICES INC
Practice address
2345 Waters Dr
Mendota Heights, MN 55120-1163
Phone
(651) 452-5600
Fax
(651) 452-6510
NPI assigned
Jul 5, 2006
Organization subpart
Yes
Parent organization
CORAM ALTERNATE SITE SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Authorized official

Name
Ashley Czonstkowsky
Title
President
Phone
(401) 765-1500

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X
Home Infusion Agency 251F00000X
Infusion Therapy Clinic/Center 261QI0500X
Durable Medical Equipment & Medical Supplies 332B00000X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 261268-7 MN
Pharmacy 333600000X 261268-7 MN
Community/Retail Pharmacy 3336C0003X 261268-7 MN
Compounding Pharmacy 3336C0004X
Home Infusion Therapy Pharmacy 3336H0001X 261268-7 MN Primary
Mail Order Pharmacy 3336M0002X 261268-7 MN
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

2345 Waters Dr
Mendota Heights, MN 55120-1163

Mailing address

PO Box 646674
Cincinnati, OH 45264-6674
Phone (720) 895-3211

Other identifiers 2

IdentifierTypeStateIssuer
2421662OtherNCPDP
261268-7OtherMNRX LICENSE

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN3 enrollments
Home infusion therapy
Medicare-enrolled home infusion therapy supplier

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20090318000429 MN Part B Supplier - Other 9638153497 1 other NPI on this enrollment
Practice locations: Mendota Heights, MN
O20100930040248 MN DME Supplier - Pharmacy 9638153497 Practice locations: Mendota Heights, MN
O20210415002250 MN Part B Supplier - Home Infusion Therapy Supplier 9638153497 Practice locations: Mendota Heights, MN

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Coram Alternate Site Services Inc2345 Waters Dr, Mendota Heights, MN 55120-1163(651) 452-5600 Immunosuppressive Drugs|Infusion Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|External Infusion Pumps and/or Supplies|Insulin Infusion Pumps and/or Supplies|Implanted Infusion Pumps and/or Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Parenteral Nutrients|Parenteral Equipment an… Accepts assignmentParticipating since Jan 10, 2020

National Provider Directory

National Provider Directory
Tax ID family
Coram Healthcare27 organizations share this tax ID, including this one
Part of
Coram Healthcare

Other organizations with this tax ID 26

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

View all 26

Member of 1

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

Locations

2901 S Frontage Rd
Moorhead, MN 56560
Phone (218) 233-2210

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788393600000",
    "number": "1386674067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 646674",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452646674",
            "telephone_number": "720-895-3211",
            "fax_number": "303-298-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 WATERS DR",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201163",
            "telephone_number": "651-452-5600",
            "fax_number": "651-452-6510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAM ALTERNATE SITE SERVICES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORAM ALTERNATE SITE SERVICES INC",
        "enumeration_date": "2006-07-05",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A",
        "authorized_official_last_name": "CZONSTKOWSKY",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-765-1500"
    },
    "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": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "MN",
            "license": "261268-7",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MN",
            "license": "261268-7",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "261268-7",
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "MN",
            "license": "261268-7",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "MN",
            "license": "261268-7",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2421662",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RX LICENSE",
            "identifier": "261268-7",
            "state": "MN"
        }
    ],
    "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 Mendota Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.