MEDICARE: NUTRIHEALTH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian

General Provider Information

NPI Number	:	1447182456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUTRIHEALTH, LLC

Provider Business Mailing Address
First Line	:	PO BOX 67537
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07101-8009
Country	:	US
Telephone Number	:	302-400-9999
Fax Number	:	302-267-4001

Provider Business Practice Location Address
First Line	:	349 E PULASKI HWY UNIT C
Second Line	:
City	:	ELKTON
State	:	MD
Zip	:	21921-6747
Country	:	US
Telephone Number	:	302-400-9999
Fax Number	:	302-267-4001

Authorized Official
Title or Position	:	BILLING SPECIALIST
Name	:	TARA WALBRECHT
Credential	:
Telephone Number	:	302-400-9999

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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