| Organization Name: | CORAM ALTERNATE SITE SERVICES, INC. |
| NPI Number: | 1366499881 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VITO PONZIO, JR (SR VP) |
| Mailing Address: | 206 Roxalana Business Park Dunbar |
| State: | WV US |
| Postal Code: | 250642727 |
| Phone Number: | 3047681241 |
| Fax Number: | 3047680925 |
| NPI Enumeration Date: | 05/29/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 333600000X |
| License Number: | SP0552256 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | WV |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |