Coram Alternate Site Services, Inc.

LBN: Coram Alternate Site Services, Inc.
Coram Alternate Site Services, Inc. is an health care organization with primary practice located at 1009 Lark St Suite 2, Johnson City TN 37604-8217. The organization recently has 8 registered licenses in different health care specialties including Agencies / Home Health, Agencies / Home Infusion, Ambulatory Health Care Facilities / Infusion Therapy, Suppliers / Parenteral & Enteral Nutrition, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Home Infusion Therapy Pharmacy, Suppliers / Mail Order Pharmacy. Suppliers / Home Infusion Therapy Pharmacy is the primary health care specialty. Coram Alternate Site Services, Inc. can be contacted via phone (423) 434-0110, or through Lacavich, Tricia L via phone (318) 407-1785.

Contact Information

Primary practice address
1009 Lark St Suite 2 Johnson City TN 37604-8217
Phone: (423) 434-0110
Fax: (423) 434-0095
Website:
Map and Directions
Authorized official contact:
Name: Lacavich, Tricia L
Phone: (318) 407-1785

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X
Agencies / Home Infusion 251F00000X
Ambulatory Health Care Facilities / Infusion Therapy 261QI0500X
Suppliers / Parenteral & Enteral Nutrition 332BP3500X 0000001704 Tennessee
Suppliers / Pharmacy 333600000X 0000001704 Tennessee
Suppliers / Community/Retail Pharmacy 3336C0003X 0000001704 Tennessee
Suppliers / Home Infusion Therapy Pharmacy 3336H0001X 0000001704 Tennessee
Suppliers / Mail Order Pharmacy 3336M0002X 0000001704 Tennessee

Profile Details

NPI number 1518073832
LBN Legal business name Coram Alternate Site Services, Inc.
DBA Doing business as
Authorized official Lacavich, Tricia L
Entity Organization
Organization subpart 1 Yes
Enumeration date Aug 21st, 2006
Last updated Mar 7th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518073832 NPPES
North Carolina MEDICAID 0445486
North Carolina Other 4426892
North Carolina MEDICAID 7701520
North Carolina MEDICAID 145206
North Carolina MEDICAID 009111158
North Carolina Other 0000001704
North Carolina MEDICAID 008506671

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