CORAM HEALTHCARE CORPORATION OF NV (NPI# 1881639755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881639755 |
| Entity Type | Organization |
| Organization Name | CORAM HEALTHCARE CORPORATION OF NV |
| Other Organization Name | CORAM CVS/SPECIALTY INFUSION SERVICES |
| Practice Address |
1951 Ramrod Ave Ste 110 Henderson NV 89014-2400 |
| Mailing Address |
Po Box 809160 Chicago IL 60680-9160 |
| Practice Telephone | 7024534546 |
| Practice Fax Number | 7024530204 |
| Mailing Telephone | 4807655043 |
| Mailing Fax Number | 4017330211 |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2020-06-26 |
| Authorized Official Name | WILLIAM BOLGAR (PRESIDENT/TREASURER) |
| Authorized Official Telephone | 7208953211 |
| Is Organization Subpart | Y |
| Parent Organization Name | CORAM HEALTHCARE CORPORATION OF NEVADA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QI0500X |
Clinic/Center Specialization: Infusion Therapy |
N/A | NV | Ambulatory Health Care Facilities |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | PH0746 | NV | Suppliers |
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
PH0746 | NV | Suppliers |
| N | 333600000X | Pharmacy | PH0746 | NV | Suppliers |
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
PH0746 | NV | Suppliers |
| N | 251E00000X | Home Health | 722NSP-9 | NV | Agencies |
| N | 251F00000X | Home Infusion | 722NSP-9 | NV | Agencies |
| N | 3336M0002X |
Pharmacy Specialization: Mail Order Pharmacy |
PH0746 | NV | Suppliers |
| Y | 3336H0001X |
Pharmacy Specialization: Home Infusion Therapy Pharmacy |
PH0746 | NV | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | RX LICENSE | PH0746 | 01 |
| DEA | BC4540351 | 01 | |
| NCPDP | 2902852 | 01 |
| Other Name | Type Code |
|---|---|
| Coram CVS/specialty Infusion Services | Doing Business As Name - Organization |
| Street Address |
1951 RAMROD AVE STE 110 |
| City | HENDERSON |
| State | NV |
| Zip Code | 89014-2400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447857024 | Sudheer J. Surpure, Md, Dds, Inc. | Oral & Maxillofacial Surgery | Grand Canyon Oral and Facial Surgery, 1600 W. Sunset Road, Suite B, Henderson, NV 89014 | 2020-10-06 |
| 1386271740 | Fibonacci Services LLC | Counselor | 2920 N. Green Valley Pkwy, Bulding 8 & Suite 812, Henderson, NV 89014 | 2020-03-25 |
| 1508409145 | Facial Expressions Presented By K. Thomas | Home Infusion | 1520 W. Sunset Rd. Ste 130, #205, Henderson, NV 89014 | 2019-10-27 |
| 1235794595 | Marquise D Dennis | Prosthetist | 1520 W. Sunset Rd, Henderson, NV 89014 | 2019-05-02 |
| 1609359165 | Kenisha Voncille Thomas | Family Medicine | 1520 W Sunset Rd Ste 130, Henderson, NV 89014 | 2018-09-11 |
| 1841716727 | Logan Bretney | Physical Therapist | 400 S Stephanie St, Suite 310, Building 1, Henderson, NV 89014 | 2017-08-22 |
| 1912421280 | Alan Joseph Sevy | Dentist | 1485 W Warm Springs Rd Ste 101, Henderson, NV 89014 | 2017-07-28 |
| 1659805307 | Ann Marie Echevarria | Behavior Technician | 2551 N Green Valley Parkway, 410a, Henderson, NV 89014 | 2017-04-19 |
| 1366838997 | Ladwana Retic, Lcsw LLC | Case Management | 1514 Tree Top Ct, Henderson, NV 89014 | 2015-04-10 |
| 1073958393 | Ashlyn Call | Physician Assistant | 1397 Galleria Dr Ste 100, Henderson, NV 89014 | 2013-04-30 |
| Find all providers in zip 89014 | ||||
| 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 |
|---|---|---|---|---|
| 1972007169 | Advanced Isotopes of Nevada, LLC | Pharmacy | 1771 E Flamingo Rd Ste 121a, Las Vegas, NV 89119-0837 | 2018-03-21 |
| 1326488784 | Pmkm LLC | Pharmacy | 801 S Rancho Dr # 7, Las Vegas, NV 89106-3854 | 2013-07-01 |
| 1972603827 | Lifecare Pharmacy LLC | Pharmacy | 3050 E Desert Inn Rd Ste 124, Las Vegas, NV 89121-3873 | 2006-09-22 |
| 1891706610 | Home Health Infusion, Inc. | Pharmacy | 145 E Reno Ave Ste E8, Las Vegas, NV 89119-1114 | 2006-08-10 |
| 1407814064 | Western Home Care, LLC | Pharmacy | 4035 E Post Rd, Las Vegas, NV 89120-3992 | 2006-05-03 |
| 1871036079 | Rococo Enterprises Inc | Pharmacy | 200 W 5th St, Winnemucca, NV 89445-3413 | 2016-11-21 |
| 1861741837 | W Care LLC | Pharmacy | 4845 S Rainbow Blvd Ste 403, Las Vegas, NV 89103-4750 | 2012-09-05 |
| 1245336122 | Arlington Aquisition I, Inc. | Pharmacy | 6630 S Mccarran Blvd, #14, Reno, NV 89509-6135 | 2006-09-16 |
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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.