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CORAM HEALTHCARE CORPORATION OF NV

Suppliers Pharmacy Mail Order Pharmacy

Provider NPI: 1881639755

Organization Information:
Organization Name:  CORAM HEALTHCARE CORPORATION OF NV
Organization is Subpart
Authorized Official:  WILLIAM  BOLGAR  PRESIDENT/TREASURER  720-895-3211

Practice Location:
1951 RAMROD AVE STE 110 HENDERSON, NV 89014-2400 US
Tel: 702-453-4546  Fax: 702-453-0204

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

NPI Information:
NPI: 1881639755
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N3336M0002XSuppliers
Pharmacy
Mail Order Pharmacy
NVPH0746
N251E00000XAgencies
Home Health
NV722NSP-9
N251F00000XAgencies
Home Infusion
NV722NSP-9
N261QI0500XAmbulatory Health Care Facilities
Clinic/Center
NVN/A
N332B00000XSuppliers
Durable Medical Equipment & Medical Supplies
NVPH0746
N332BP3500XSuppliers
Durable Medical Equipment & Medical Supplies
NVPH0746
N333600000XSuppliers
Pharmacy
NVPH0746
N3336C0003XSuppliers
Pharmacy
NVPH0746
Y3336H0001XSuppliers
Pharmacy
NVPH0746

Other Provider Identifiers:

IssuerNumberStateType
DEABC454035101
RX LICENSEPH0746NV01
NCPDP290285201



American Medical Association 2012 taxonomy code information

Code: 3336H0001X

Type:

Classification:



Definition:



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