Active NPI
Coram Alternate Site Services Inc
- Home Infusion Agency
- Denver, CO
National Provider Identifier
1609899590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Infusion Agency
- Legal business name
- CORAM ALTERNATE SITE SERVICES INC
- Practice address
- 1500 Wynkoop St
Denver, CO 80202-1150 - Phone
- (303) 799-0093
- Fax
- (303) 790-0633
- NPI assigned
- Jul 25, 2006
- Organization subpart
- Yes
- Parent organization
- CORAM ALTERNATE SITE SERVICES INC
NPPES NPI Registry
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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | |||
| Home Infusion Agency | 251F00000X | Primary | ||
| Infusion Therapy Clinic/Center | 261QI0500X | 370000024 | CO | |
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Parenteral & Enteral Nutrition Supplies (DME) | 332BP3500X | 370000024 | CO | |
| Pharmacy | 333600000X | 370000024 | CO |
Addresses
Primary practice location
1500 Wynkoop St
Denver, CO 80202-1150
Mailing address
PO Box 809160
Chicago, IL 60680-9160
Phone (480) 765-5043
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0614380 | Other | NCPDP | |
| 03002565 | Medicaid | CO | |
| 370000024 | Other | CO | RX LICENSE |
Other names 1
- Coram CVS/specialty Infusion Services
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
12450 E Arapahoe Rd
Ste A1
Centennial, CO 80112
Phone (303) 799-0093
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1678147200000",
"number": "1609899590",
"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": "1500 WYNKOOP ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802021150",
"telephone_number": "303-799-0093",
"fax_number": "303-790-0633"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CORAM ALTERNATE SITE SERVICES INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CORAM ALTERNATE SITE SERVICES INC",
"enumeration_date": "2006-07-25",
"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": null,
"license": null,
"primary": false
},
{
"code": "251F00000X",
"taxonomy_group": "",
"desc": "Home Infusion",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QI0500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Infusion Therapy",
"state": "CO",
"license": "370000024",
"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": "CO",
"license": "370000024",
"primary": false
},
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "CO",
"license": "370000024",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "0614380",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03002565",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RX LICENSE",
"identifier": "370000024",
"state": "CO"
}
],
"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 Denver, CO
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.