Coram Alternate Site Services Inc is a Specialty Pharmacy based in Chicago, CA and is specialized in Specialty Pharmacy. Coram Alternate Site Services Inc practices in San Diego, CA. The NPI Number for Coram Alternate Site Services Inc is 1790734036 and holds a License No. 0800429 (California).
The current practice location address for Coram Alternate Site Services Inc is 12310 World Trade Dr, San Diego, CA and can be reached out via phone at 858-576-6969 and via fax at 858-974-6606.
Location: 12310 World Trade Dr, San Diego, CA, 60680-9160
Provider Profile Details
NPI Number
1790734036
Provider Name
Coram Alternate Site Services Inc
Credential
Provider Entity Type
Organization
Address
12310 World Trade Dr, San Diego, CA, 60680-9160
Phone Number
858-576-6969
Fax Number
858-974-6606
Provider Enumeration Date
05/05/2006
Last Update Date
03/12/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0522311 | 01 | NCPDP | |
| PHA409320 | 05 | CA | |
| 101225 | 01 | CA | MEDICAL DEVICE RETAILER |
| 0800429 | 01 | CA | HOME HEALTH AGENCY |
| PHY50273 | 01 | CA | PHARMACY LICES |
Provider Business Practice Location Address Details
Address
12310 World Trade Dr
City
State
Zip
92128-3793
Phone Number
858-576-6969
Fax Number
858-974-6606
Provider Business Mailing Address Details
Address
12310 World Trade Dr
City
State
Zip
92128-3793
Phone Number
858-576-6969
Fax Number
858-974-6606
Provider's Taxonomy Details 1
Type
Agencies
Classification
Home Health
Speciality
-
Taxonomy
License No.
PHY50273 (California)
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
Provider's Taxonomy Details 2
Type
Agencies
Classification
Home Infusion
Speciality
-
Taxonomy
License No.
PHY50273 (California)
Definition
Definition to come...
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Infusion Therapy
Taxonomy
License No.
PHY50273 (California)
Definition
Definition to come...
Provider's Taxonomy Details 4
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
License No.
PHY50273 (California)
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
Provider's Taxonomy Details 5
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
Parenteral & Enteral Nutrition
Taxonomy
License No.
PHY50273 (California)
Definition
Definition to come...
Provider's Taxonomy Details 6
Type
Suppliers
Classification
Pharmacy
Speciality
-
Taxonomy
License No.
PHY50273 (California)
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.
Provider's Taxonomy Details 7
Type
Suppliers
Classification
Pharmacy
Speciality
Community/Retail Pharmacy
Taxonomy
License No.
PHY50273 (California)
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
Provider's Taxonomy Details 8
Type
Suppliers
Classification
Pharmacy
Speciality
Compounding Pharmacy
Taxonomy
License No.
PHY50273 (California)
Definition
A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.
Provider's Taxonomy Details 9
Type
Suppliers
Classification
Pharmacy
Speciality
Home Infusion Therapy Pharmacy
Taxonomy
License No.
(California)
Definition
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.
Provider's Taxonomy Details 10
Type
Suppliers
Classification
Pharmacy
Speciality
Mail Order Pharmacy
Taxonomy
License No.
0800429 (California)
Definition
A pharmacy where pharmacists compound or dispense prescriptions or other medications in accordance with federal and state law, using common carriers to deliver the medications to patient or their caregivers. Mail order pharmacies counsel patients and caregivers (sometimes independent of the dispensing process) through telephone or email contact and provide other professional services associated with pharmaceutical care appropriate to the setting. Mail order pharmacies are licensed as a Mail Order Pharmacy in the state where they are located and may also be licensed or registered as nonresident pharmacies in other states.
Provider's Taxonomy Details 11
Type
Suppliers
Classification
Pharmacy
Speciality
Specialty Pharmacy
Taxonomy
License No.
0800429 (California)
Definition
A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration.
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