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General NPI Number Information
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NPI Number | 1528852308
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Entity Type | Organization
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Legal Business Name | CORE PATH MEDICAL LLC
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Dates
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Enumeration Date | 04/07/2025
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 4900 LEESBURG PIKE
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City | ALEXANDRIA
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State | VA
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Zip | 22302-1103
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Country | US
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Telephone | 703-310-6864
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Fax | 804-597-2156
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Provider Business Mailing Address
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Address Line | 4900 LEESBURG PIKE
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City | ALEXANDRIA
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State | VA
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Zip | 22302-1103
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Country | US
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Telephone | 703-310-6864
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Fax | 804-597-2156
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHABANA KHAN
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Credential |
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Telephone | 703-310-6864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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