NPIMap

Organization Active NPI

Coram Healthcare of Wyoming, LLC

  • Infusion Therapy Clinic/Center
  • Cheyenne, WY
National Provider Identifier
1720035249
Registry record updated Oct 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X
License
N/A Issued in WY
Legal business name
CORAM HEALTHCARE OF WYOMING, LLC
Practice address
1507 Stillwater Ave
Suite C
Cheyenne, WY 82009-7358
Phone
(307) 635-3785
Fax
(307) 635-7002
NPI assigned
May 29, 2006
Organization subpart
Yes
Parent organization
CORAM HEALTHCARE OF WYOMING, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2007

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

Authorized official

Name
Vito Ponzio, Jr
Title
Sr VP
Phone
(303) 672-8631

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Clinic/Center 261QI0500X N/A WY Primary

Addresses

Primary practice location

1507 Stillwater Ave
Suite C
Cheyenne, WY 82009-7358

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
Coram Healthcare of Wyo2 organizations share this tax ID, including this one
Part of
Coram Healthcare of Wyo

Other organizations with this tax ID 1

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

Locations

1507 Stillwater Ave
Ste C
Cheyenne, WY 82009
Phone (307) 635-3785

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": "1191801600000",
    "number": "1720035249",
    "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": "1507 STILLWATER AVE",
            "address_2": "SUITE C",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820097358",
            "telephone_number": "307-635-3785",
            "fax_number": "307-635-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORAM HEALTHCARE OF WYOMING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CORAM HEALTHCARE OF WYOMING, LLC",
        "enumeration_date": "2006-05-29",
        "last_updated": "2007-10-08",
        "status": "A",
        "authorized_official_last_name": "PONZIO, JR",
        "authorized_official_first_name": "VITO",
        "authorized_official_title_or_position": "SR VP",
        "authorized_official_telephone_number": "303-672-8631"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "WY",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2007; 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.