Coram Alternate Site Services INC
Pharmacy, Home Infusion Therapy Pharmacy in San Diego, CA. Organization (NPI-2).
NPI number1790734036
StatusActive
Last updated in NPPESSep 3, 2026
Details
- NPI
- 1790734036
- Entity type
- Organization (NPI-2)
- Legal business name
- Coram Alternate Site Services INC
- Organization subpart
- Yes
- Enumeration date
- May 5, 2006
- Certification date
- Sep 3, 2026
- Last updated
- Sep 3, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336H0001X | Pharmacy, Home Infusion Therapy Pharmacy | PHY50273 | CA | Yes |
| 251E00000X | Home Health | 0800429 | CA | |
| 251F00000X | Home Infusion | 0800429 | CA | |
| 261QI0500X | Clinic/Center, Infusion Therapy | – | CA | |
| 332B00000X | Durable Medical Equipment & Medical Supplies | PHY50273 | CA | |
| 332BP3500X | Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition | PHY50273 | CA | |
| 333600000X | Pharmacy | PHY50273 | CA | |
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | PHY50273 | CA | |
| 3336C0004X | Pharmacy, Compounding Pharmacy | PHY50273 | CA | |
| 3336M0002X | Pharmacy, Mail Order Pharmacy | PHY50273 | CA | |
| 3336S0011X | Pharmacy, Specialty Pharmacy | PHY50273 | CA |
Other names
- Coram Cvs/Specialty Infusion Services (Doing Business As)
Practice location
12310 World Trade DrSuite 100
San Diego, CA 92128-3793
Phone 858-576-6969 · Fax 858-974-6606
Mailing address
Po Box 646674Cincinnati, OH 45264-6674
Phone 480-765-5043 · Fax 401-733-0211
Authorized official
Ashley Czonstkowsky
President
4017651500
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All 7 Home Infusion Therapy Pharmacy providers in San Diego · All 61,118 providers in San Diego
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