MEDICARE: COREVITA MEDICAL EQUIPMENT 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1669399325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COREVITA MEDICAL EQUIPMENT LLC

Provider Business Mailing Address
First Line	:	10316 SPRING IRIS DR
Second Line	:
City	:	BRISTOW
State	:	VA
Zip	:	20136-2227
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10316 SPRING IRIS DR
Second Line	:
City	:	BRISTOW
State	:	VA
Zip	:	20136-2227
Country	:	US
Telephone Number	:	385-384-2482
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	TOOBA BASHARAT
Credential	:
Telephone Number	:	385-384-2482

Provider Enumeration Date	:	07/02/2026
Last Update Date	:	07/02/2026

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Directions to “COREVITA MEDICAL EQUIPMENT LLC ” Practice Location

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