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CORAM ALTERNATE SITE SERVICES, INC.

Agencies Home Health

Provider NPI: 1528345519

Organization Information:
Organization Name:  CORAM ALTERNATE SITE SERVICES, INC.
Organization is Subpart
Authorized Official:  SANDY L CAMPA  SR. CONSULTANT PAYER RELATIONS  909-799-4174

Practice Location:
5511 E 3RD AVE  SPOKANE VALLEY, WA 99212-0726 US
Tel: 509-482-4266  Fax: 509-482-4270

Business Mailing Address:
PO BOX 809160  CHICAGO, IL 60680-9160 US
Tel: 866-224-5134  Fax: --

NPI Information:
NPI: 1528345519
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N251E00000XAgencies
Home Health
N251F00000XAgencies
Home Infusion
N261QI0500XAmbulatory Health Care Facilities
Clinic/Center
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
N332BP3500XSuppliers
Durable Medical Equipment & Medical Supplies
N333600000XSuppliers
Pharmacy
N3336C0004XSuppliers
Pharmacy
N3336M0002XSuppliers
Pharmacy
N3336S0011XSuppliers
Pharmacy
Y3336H0001XSuppliers
Pharmacy

Other Provider Identifiers:

IssuerNumberStateType
PHARMACY PERMITPHAR.CF.60470283WA01
DEABA418723601
NCPDP493464701



American Medical Association 2012 taxonomy code information

Code: 3336H0001X

Type:

Classification:



Definition:



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