MEDICARE: CORE VALUE CORPORATION

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	133V00000X	Registered Dietitian	D02284	MD

General Provider Information

NPI Number	:	1265961247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE VALUE CORPORATION

Provider Business Mailing Address
First Line	:	4560 CRAIN HWY STE 12
Second Line	:
City	:	WHITE PLAINS
State	:	MD
Zip	:	20695-3084
Country	:	US
Telephone Number	:	240-210-9725
Fax Number	:	240-366-1161

Provider Business Practice Location Address
First Line	:	4560 CRAIN HWY STE 12
Second Line	:
City	:	WHITE PLAINS
State	:	MD
Zip	:	20695-3084
Country	:	US
Telephone Number	:	240-210-9725
Fax Number	:	240-366-1161

Authorized Official
Title or Position	:	CEO
Name	:	LISA HUGH
Credential	:
Telephone Number	:	240-210-9725

Provider Enumeration Date	:	06/05/2017
Last Update Date	:	07/21/2022

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Directions to “CORE VALUE CORPORATION ” Practice Location

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