Provider Demographics
NPI:1366574469
Name:CORAM CLINICAL TRIALS, INC.
Entity type:Organization
Organization Name:CORAM CLINICAL TRIALS, INC.
Other - Org Name:
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:303-762-8631
Mailing Address - Street 1:555 17TH ST
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-3950
Mailing Address - Country:US
Mailing Address - Phone:303-672-8631
Mailing Address - Fax:303-298-0047
Practice Address - Street 1:555 17TH ST
Practice Address - Street 2:SUITE 1500
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-3950
Practice Address - Country:US
Practice Address - Phone:303-672-8631
Practice Address - Fax:303-298-0047
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CORAM LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-12
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management