CORAM ALTERNATE SITE SERVICES, INC. (NPI# 1669759650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669759650 |
| Entity Type | Organization |
| Organization Name | CORAM ALTERNATE SITE SERVICES, INC. |
| Other Organization Name | CORAM CVS/SPECIALTY INFUSION SERVICES |
| Practice Address |
12120 Colonel Glenn Rd Ste 8000 Little Rock AR 72210-2847 |
| Mailing Address |
Po Box 809160 Chicago IL 60680-9160 |
| Practice Telephone | 5013121655 |
| Practice Fax Number | 5013121514 |
| Mailing Telephone | 3036728631 |
| Mailing Fax Number | 3032980047 |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2019-08-19 |
| Authorized Official Name | SANDY L CAMPA (SR CONSULTANT) |
| Authorized Official Telephone | 9097994174 |
| Is Organization Subpart | Y |
| Parent Organization Name | CORAM ALTERNATE SITE SERVICES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| 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 | ||
| Y | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
Suppliers | ||
| N | 3336S0011X |
Pharmacy Specialization: Specialty Pharmacy |
Suppliers | ||
| N | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | DEA | BA7266061 | 01 |
| AR | PHARMACY | AR20263 | 01 |
| AR | NCDPD | 0423931 | 01 |
| Other Name | Type Code |
|---|---|
| Coram CVS/specialty Infusion Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770075152 | Coram Alternate Site Services, Inc. | Home Health | 8910 W 192nd St Ste J, Mokena, IL 60448-8111 | 2018-06-01 |
| 1619478047 | Coram Alternate Site Services, Inc. | Pharmacy | 4601 E Hilton Ave Ste 105, Phoenix, AZ 85034-6406 | 2018-02-21 |
| 1295192565 | Coram Alternate Site Services, Inc. | Durable Medical Equipment & Medical Supplies | 136 S Mckinley St, Casper, WY 82601-2745 | 2016-01-18 |
| 1528498490 | Coram Alternate Site Services, Inc. | Home Health | 3101 N Sillect Ave, Ste 109, Bakersfield, CA 93308-6348 | 2013-11-13 |
| 1871926030 | Coram Alternate Site Services, Inc. | Clinic/Center | 4317 Bluebonnet Blvd Ste B, Baton Rouge, LA 70809-9643 | 2013-08-12 |
| 1053663906 | Coram Alternate Site Services, Inc. | Home Infusion | 101 East Silver Springs Blvd, Suite 202, Ocala, FL 34470-6605 | 2012-10-02 |
| 1861760233 | Coram Alternate Site Services, Inc. | Home Infusion | 555 Winderley Pl Ste 300, Maitland, FL 32751-7133 | 2011-12-13 |
| 1932477809 | Coram Alternate Site Services, Inc. | Home Health | 12 Northbrook Dr Ste 1, Falmouth, ME 04105-1318 | 2011-12-07 |
| 1003183401 | Coram Alternate Site Services, Inc. | Home Health | 8201 E 34th Street Cir N Ste 905, Wichita, KS 67226-1364 | 2011-11-30 |
| 1629355482 | Coram Alternate Site Services, Inc. | Home Health | 11711 N College Ave Ste 125, Carmel, IN 46032-5634 | 2011-11-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CORAM ALTERNATE SITE SERVICES, INC. | One Cvs Drive, Woonsocket, RI 02895 |
| Iowa Business Entities | CORAM ALTERNATE SITE SERVICES, INC. | One Cvs Drive, Woonsocket, RI 02895 |
| Vermont Business Registrations | CORAM ALTERNATE SITE SERVICES, INC. | 555 17th Street, Suite 1500, Denver, CO 80202 |
| Oklahoma Business Registrations | CORAM ALTERNATE SITE SERVICES, INC. | 1125 17th St 15th Floor, Denver, CO 80202 |
| Washington State Corporations | CORAM ALTERNATE SITE SERVICES, INC. | 1 Cvs Dr, Woonsocket, RI 02895-6146 |
| New York State Corporations | CORAM ALTERNATE SITE SERVICES, INC. | 1 Cvs Drive, Woonsocket, Ri 02895 |
| Colorado Business Entities | CORAM ALTERNATE SITE SERVICES, INC. | 1 Cvs Drive, Woonsocket, RI 02895 |
| Street Address |
12120 COLONEL GLENN RD STE 8000 |
| City | LITTLE ROCK |
| State | AR |
| Zip Code | 72210-2847 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487290888 | John Hunter Bramlitt | Counselor | 12320 I-30, Little Rock, AR 72210 | 2019-11-20 |
| 1972159267 | Arkansas Baptist Children's Homes and Family Ministries | Counselor | 12400 I-30, Little Rock, AR 72210 | 2019-08-13 |
| 1952956864 | Hanrietta Evans | Behavior Technician | Youth Home Inc, 20302 Colonel Glenn Rd, Little Rock, AR 72210 | 2019-08-07 |
| 1821597287 | Deanna Smith | Counselor | 12320 I-30 Frontage Road, Little Rock, AR 72210 | 2018-02-12 |
| 1922485481 | Whitney Brown | Social Worker | 20400 Colonel Glenn, Little Rock, AR 72210 | 2015-05-04 |
| 1679978191 | Jennifer Black | Counselor | 20302 Col Glenn Road, Little Rock, AR 72210 | 2014-10-27 |
| 1831593896 | James William Takach | Family Medicine | 14519 Wimbledon Loop, Little Rock, AR 72210 | 2014-10-20 |
| 1811319734 | Ben Malone | Case Manager/Care Coordinator | 20400 Col Glenn Road, Little Rock, AR 72210 | 2014-01-12 |
| 1487924296 | Tara Brown | Case Manager/Care Coordinator | 20302 Colonel Glenn Rd., Little Rock, AR 72210 | 2012-01-10 |
| 1972889061 | D. Rachelle Rial | Case Manager/Care Coordinator | 20400 Col Glenn Rd., Little Rock, AR 72210 | 2011-11-02 |
| Find all providers in zip 72210 | ||||
| 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 |
|---|---|---|---|---|
| 1538591979 | Chi National Home Care | Pharmacy | 10303 Colonel Glenn Rd, Suite 1f, Little Rock, AR 72204-8146 | 2013-08-08 |
| 1568678613 | I Care of Arkansas, Inc. | Pharmacy | 1527 S Bowman Rd, Suite D, Little Rock, AR 72211-4207 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154704062 | Heritage Senior Care LLC | Pharmacy | 607 W Main St Ste B, Jacksonville, AR 72076-4431 | 2015-07-09 |
| 1902298342 | Precision Health Care, Inc | Pharmacy | 113 Parkwood St Ste A, Parkwood Suites Two, Lowell, AR 72745-8811 | 2015-02-23 |
| 1629377742 | Cornerstone Specialty Pharmacy LLC | Pharmacy | 1450 E Zion Rd Ste 1, Fayetteville, AR 72703-4988 | 2011-03-16 |
| 1558383414 | North Central I V & Respiratory Specialists LLC | Pharmacy | 202 E Washington Ave, Jonesboro, AR 72401-3102 | 2006-07-23 |
| 1477728772 | Advanced Home Iv Services | Pharmacy | 1235 Sturgis Rd Ste 7, Conway, AR 72034-9688 | 2008-04-28 |
| 1609990100 | Home I.v. Specialists, Inc. | Pharmacy | 200 S Main St, Jonesboro, AR 72401-2907 | 2007-03-19 |
| 1407920242 | Home I.v. Specialists, Inc. | Pharmacy | 200 S Main St, Jonesboro, AR 72401-2907 | 2006-11-20 |
| City | LITTLE ROCK |
| Zip Code | 72210 |
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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.