CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK (NPI# 1396021598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396021598 |
| Entity Type | Organization |
| Organization Name | CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK |
| Other Organization Name | CORAM CVS/SPECIALTY INFUSION SERVICES |
| Practice Address |
2949 Erie Blvd E Ste 103 Syracuse NY 13224-1447 |
| Mailing Address |
Po Box 809160 Chicago IL 60680-9160 |
| Practice Telephone | 3154258028 |
| Practice Fax Number | 3154250989 |
| Mailing Telephone | 4807655043 |
| Mailing Fax Number | 4017330211 |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2020-06-26 |
| Authorized Official Name | SANDY L CAMPA (SR CONSULTANT) |
| Authorized Official Telephone | 9097994174 |
| Is Organization Subpart | Y |
| Parent Organization Name | CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| N | 251F00000X | Home Infusion | Agencies | ||
| N | 261QI0500X |
Clinic/Center Specialization: Infusion Therapy |
Ambulatory Health Care Facilities | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| N | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| Y | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 5804566 | 01 | |
| NY | PHARMACY PERMIT | 031097 | 01 |
| DEA | FC0024771 | 01 |
| Other Name | Type Code |
|---|---|
| Coram CVS/specialty Infusion Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912523663 | Coram Healthcare Corporation of Greater New York | Home Health | 20 Madison Avenue Ext Ste 5, Albany, NY 12203-5326 | 2020-06-18 |
| 1427394915 | Coram Healthcare Corporation of Greater New York | Home Infusion | 510 Clinton Sq, Rochester, NY 14604-1700 | 2013-01-02 |
| 1508136060 | Coram Healthcare Corporation of Greater New York | Home Infusion | 300 Enterprise Dr Ste 506, Kingston, NY 12401-7004 | 2011-12-30 |
| 1710033923 | Coram Healthcare Corporation of Greater New York | Home Health | 1675 Broadway, Suite 900, Denver, CO 80202-4675 | 2007-01-28 |
| 1568474716 | Coram Healthcare Corporation of Greater New York | Home Health | 4823 55th Ave, Flushing, NY 11378-1026 | 2006-08-13 |
| 1063424216 | Coram Healthcare Corporation of Greater New York | Home Health | 97-77 Queens Blvd, Suite 1100, Rego Park, NY 11374-2101 | 2006-08-13 |
| 1679859862 | Coram Healthcare Corporation of Greater New York | Home Health | 375 N French Rd Ste 108, Amherst, NY 14228-2009 | 2011-11-01 |
| 1891071098 | Coram Healthcare Corporation of Greater New York | Durable Medical Equipment & Medical Supplies | 12 Jupiter Ln, Albany, NY 12205-6918 | 2011-11-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK | 555 17th Street, Suite 1500, Denver, CO 80202 |
| Vermont Business Registrations | CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK | 555 17th Street, Suite 1500, Denver, CO 80202 |
| New York State Corporations | CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK | 28 Liberty St., New York, Ny 10005 |
| Street Address |
2949 ERIE BLVD E STE 103 |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13224-1447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598329534 | Judie Lyn Gordon-louison | Registered Nurse | 2429 East Fayette Street, Syracuse, Syracuse, NY 13224 | 2019-04-25 |
| 1669942363 | Julie E. Clonan | Speech-Language Pathologist | 3049 E. Genesee St., Syracuse, NY 13224 | 2018-11-26 |
| 1043604762 | Heather Lynn Blum | Licensed Practical Nurse | 120 Niven Street, Syracuse, NY 13224 | 2015-03-19 |
| 1912226523 | Florence Delisi | Licensed Practical Nurse | 2315 East Fayette St, Syracuse, NY 13224 | 2010-05-21 |
| 1336476563 | Kimberlee Anne Difulio | Licensed Practical Nurse | 1615 Meadowbrook Drive, #3, Syracuse, NY 13224 | 2009-11-09 |
| 1134371081 | Amy Lynn Ezekiel | Speech-Language Pathologist | 3049 East Genesee Street, Syracuse, NY 13224 | 2008-10-22 |
| 1104951490 | Daniel Stephen Delluomo | Dentist | 3175 East Genesee St, Suite 2, Syracuse, NY 13224 | 2007-02-23 |
| 1447317037 | Fumiyo Hirano | Social Worker | 182 Edgehill Road, Syracuse, NY 13224 | 2007-01-02 |
| 1295811198 | Mark A Matloff | Psychologist | 409 Standish Drive, Syracuse, NY 13224 | 2006-10-31 |
| 1235222530 | Bernadine Alese Martin | Dentist | 1125 Salt Springs Road, Syracuse, NY 13224 | 2006-10-02 |
| Find all providers in zip 13224 | ||||
| Taxonomy Code | 3336H0001X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Home Infusion Therapy Pharmacy |
| Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance. |
| Notes: Source: National Home Infusion Association [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487194874 | Cottrills Pharmacy Inc | Pharmacy | 4919 Ellicott Rd, Orchard Park, NY 14127-3357 | 2017-03-03 |
| 1477890861 | Global Pharmacy Inc | Pharmacy | 1910 South Rd Ste B, Poughkeepsie, NY 12601-6027 | 2013-01-07 |
| 1952433757 | Western New York Bloodcare, Inc. | Pharmacy | 1010 Main St Ste 300, Buffalo, NY 14202-1102 | 2007-03-09 |
| 1265596019 | Genesee Valley Group Health Association | Pharmacy | 535 Summit Point Dr, Suite #3, Henrietta, NY 14467-9606 | 2006-12-19 |
| 1538242953 | Pharmacy Solution Services LLC | Pharmacy | 140 Keyland Court Unit 28, Bohemia, NY 11716-2655 | 2006-10-21 |
| 1053408534 | Lake Erie Home Care, Inc. | Pharmacy | 5763 Seneca St, Elma, NY 14059-9800 | 2006-10-06 |
| 1679678049 | Americare Pharmaceutical Services,inc. | Pharmacy | 317 Nassau Blvd, Garden City, NY 11530-5313 | 2006-09-13 |
| 1598705386 | Empire Home Infusion Service Inc | Pharmacy | 10 Blacksmith Dr, Suite 2, Malta, NY 12020-4428 | 2006-06-08 |
| 1992777510 | Regioncare Inc. | Pharmacy | 200 Community Dr, Great Neck, NY 11021 | 2006-02-07 |
| 1689655359 | Town Total Nutrition Inc | Pharmacy | 6 E 32nd St Fl 5, New York, NY 10016-5422 | 2005-11-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.