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CORAM ALTERNATE SITE SERVICES, INC.

Company Details

Name: CORAM ALTERNATE SITE SERVICES, INC.
Jurisdiction: Idaho
Legal type: Foreign Business Corporation
Status: Active-Good Standing
Date of registration: 30 Mar 1995 (30 years ago)
Financial Date End: 31 Mar 2026
Entity Number: 338973
Place of Formation: DELAWARE
File Number: 338973
Principal Address: ONE CVS DRIVE WOONSOCKET, RI 2895
Mailing Address: ONE CVS DRIVE WOONSOCKET, RI 02895

Agent

Name Role Address
C T CORPORATION SYSTEM Agent 1555 W SHORELINE DR, STE 100, BOISE, ID 83702

President

Name Role Address Appointed On Resigned On
WILLIAM J BOLGAR President 12600 EAST ARAPAHOE ROAD, CENTENNIAL, CO 80112 2021-03-03 2022-03-03
TRICIA LACAVICH President 1 CVS DRIVE, WOONSOCKET, RI 02895 2024-02-13 2024-02-13

Vice President

Name Role Address Appointed On
THOMAS S MOFFATT Vice President 1 CVS DRIVE, WOONSOCKET, RI 02895 2022-03-03
Thomas S. Moffatt Vice President ONE CVS DRIVE, WOONSOCKET, RI 02895 2025-02-10

Treasurer

Name Role Address Appointed On Resigned On
TRICIA LACAVICH Treasurer 1 CVS DRIVE, WOONSOCKET, RI 02895 2024-02-13 2024-02-13

Director

Name Role Address Appointed On Resigned On
TRICIA LACAVICH Director 1 CVS DRIVE, WOONSOCKET, RI 02895 2024-02-13 2024-02-13
THOMAS S MOFFATT Director 1 CVS DRIVE, WOONSOCKET, RI 02895 2024-02-13 2024-02-13

Secretary

Name Role Address Appointed On Resigned On
THOMAS S MOFFATT Secretary 1 CVS DRIVE, WOONSOCKET, RI 02895 2024-02-13 2024-02-13

National Provider Identifier

NPI Number:
1912953431
Certification Date:
2024-03-09

Authorized Person:

Name:
CRAIG S WEINERT
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
251E00000X - Home Health Agency
Is Primary:
No
Selected Taxonomy:
251F00000X - Home Infusion Agency
Is Primary:
No
Selected Taxonomy:
261QI0500X - Infusion Therapy Clinic/Center
Is Primary:
No
Selected Taxonomy:
332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary:
No
Selected Taxonomy:
332BP3500X - Parenteral & Enteral Nutrition Supplies (DME)
Is Primary:
No

Contacts:

Fax:
3032980047
Fax:
2083230381

Filing

Filing Name Filing Number Filing date
Annual Report 0006103119 2025-02-10
Annual Report 0005601667 2024-02-13
Annual Report 0005153546 2023-03-13
Registered Agent Name/Address Change (mass change) 0004898361 2022-09-12
Annual Report 0004628767 2022-03-03

Date of last update: 08 May 2025

Sources: Idaho Secretary of State