CORAM HEALTHCARE/CAROLINA HOME THERAPEUTICS
Mail Order Pharmacy
Columbia, South Carolina
Provider NPI: 1134131352
Organization Information:Practice Location:
720 GRACERN RD SUITE 123 COLUMBIA, SC 29210 US
Tel: 803-731-5076 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 251E00000X | Agencies Home Health | ||
| N | 251F00000X | Agencies Home Infusion | ||
| N | 261QI0500X | Ambulatory Health Care Facilities Clinic/Center | ||
| N | 332BP3500X | Suppliers Durable Medical Equipment & Medical Supplies | SC | 50-004889 |
| N | 333600000X | Suppliers Pharmacy | SC | 50-004889 |
| N | 3336C0003X | Suppliers Pharmacy | SC | 50-004889 |
| N | 3336M0002X | Suppliers Pharmacy | SC | 50-004889 |
| Y | 3336H0001X | Suppliers Pharmacy | SC | 50-004889 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| NCPDP | 4219362 | 01 | |
| DEA | BC1766217 | 01 | |
| RX LICENSE | 10-04889 | SC | 01 |
| 0334970001 | SC | 07 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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