MEDICARE: CORE HEALTH SERVICES 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	111N00000X	Chiropractor	SC268	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134328461
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	4122 W BELTLINE BLVD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-1509
Country	:	US
Telephone Number	:	803-254-6730
Fax Number	:	803-254-6323

Provider Business Practice Location Address
First Line	:	4122 W BELTLINE BLVD
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29204-1509
Country	:	US
Telephone Number	:	803-254-6730
Fax Number	:	803-254-6323

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. TROY B MARTIN
Credential	:	DC
Telephone Number	:	803-254-6730

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	07/17/2007

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Directions to “CORE HEALTH SERVICES LLC ” Practice Location

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