| NPI | 1790734036 |
|---|---|
| Doing Business As | CORAM CVS/SPECIALTY INFUSION SERVICES |
| Entity Type | Organization |
| Authorized Contact | TRICIA LACAVICH President 314-306-3255 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: CA PHY50273) |
| Additional Taxonomies | 251E00000X Home Health (Licence: CA 0800429) |
| 251F00000X Home Infusion (Licence: CA 0800429) | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CA PHY50273) | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: CA PHY50273) | |
| 333600000X Pharmacy (Licence: CA PHY50273) | |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: CA PHY50273) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: CA PHY50273) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: CA PHY50273) | |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: CA PHY50273) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2023-03-07 |