NPI 1114511490

Coram Alternate Site Services, INC.

Organisation Home Infusion Agency Champaign, IL

Practice location

Address: 2022 Glenn Park Dr, Champaign, IL 61821-2405
Phone: (217) 356-7900
Mailing address: PO Box 809160, Chicago, IL 60680-9160

Authorised official

Name: Tricia Lacavich
Title: President
Phone: (314) 306-3255

Registered specialties (4)

Home Infusion Agency Primary

Agencies Taxonomy 251F00000X

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Infusion Therapy Registered Nurse

Nursing Service Providers Taxonomy 163WI0500X

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Home Health Agency

Agencies Taxonomy 251E00000X

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Nursing Care Agency

Agencies Taxonomy 251J00000X

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Registry record

NPI: 1114511490
Entity type: Organization
NPI issued: 26 Feb 2021
Record last updated: 19 Oct 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.