Provider Demographics
NPI:1427394915
Name:CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK
Entity type:Organization
Organization Name:CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KEPLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-672-8812
Mailing Address - Street 1:555 17TH ST STE 1500
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-3900
Mailing Address - Country:US
Mailing Address - Phone:303-672-8812
Mailing Address - Fax:303-298-0047
Practice Address - Street 1:510 CLINTON SQ
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14604-1700
Practice Address - Country:US
Practice Address - Phone:716-691-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORAM HEALTHCARE CORPORATION OF GREATER NEW YORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-02
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion