| Organization Name: | CORAM HEALTHCARE CORPORATION OF GREATER D.C. |
| NPI Number: | 1063681807 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VITO PONZIO (SR VP AND DIRECTOR) |
| Mailing Address: | 4115 Pleasant Valley Rd Ste 600 Chantilly |
| State: | VA US |
| Postal Code: | 201511223 |
| Phone Number: | 7036311611 |
| Fax Number: | 7036316738 |
| NPI Enumeration Date: | 02/26/2008 |
| NPI Last Update Date: | 02/26/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QI0500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Infusion Therapy |
| Taxonomy Definition: | |