Organization · Type 2 NPI

Coram Alternate Site Services Inc

Home Infusion Therapy Pharmacy · Mendota Heights, MN

NPI number 1386674067 Active

Practice location

2345 Waters Dr
Mendota Heights, MN 55120-1163

Call (651) 452-5600 Map

Fax (651) 452-6510

Mailing address

PO Box 646674
Cincinnati, OH 45264-6674

Specialties and licenses

Taxonomy	Code	License
Home Health Agency	251E00000X	None listed
Home Infusion Agency	251F00000X	None listed
Infusion Therapy Clinic/Center	261QI0500X	None listed
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Parenteral & Enteral Nutrition Supplies (DME)	332BP3500X	261268-7 (MN)
Pharmacy	333600000X	261268-7 (MN)
Community/Retail Pharmacy	3336C0003X	261268-7 (MN)
Compounding Pharmacy	3336C0004X	None listed
Home Infusion Therapy Pharmacy Primary	3336H0001X	261268-7 (MN)
Mail Order Pharmacy	3336M0002X	261268-7 (MN)
Specialty Pharmacy	3336S0011X	None listed

Home Infusion Therapy Pharmacy: 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, infusio…

6 other providers at this address

NPI record

NPI: 1386674067
Entity type: Organization (Type 2)
Issued: Jul 5, 2006
Last updated: Sep 3, 2026
Status: Active
Subpart: Yes of Coram Alternate Site Services Inc

Other names

<unavail>
Coram Cvs/specialty Infusion Services · doing business as
Coram Cvs/specialty Infusion Services · doing business as

Authorized official

Ashley Czonstkowsky
President
(401) 765-1500

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1386674067

Coram Alternate Site Services Inc's National Provider Identifier is 1386674067, issued on Jul 5, 2006. The primary taxonomy on file is Home Infusion Therapy Pharmacy (3336H0001X), and the practice location is in Mendota Heights, MN. The record was last updated on Sep 3, 2026.