Provider Demographics
NPI:1528852308
Name:CORE PATH MEDICAL LLC
Entity type:Organization
Organization Name:CORE PATH MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHABANA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-310-6864
Mailing Address - Street 1:4900 LEESBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-1103
Mailing Address - Country:US
Mailing Address - Phone:703-310-6864
Mailing Address - Fax:804-597-2156
Practice Address - Street 1:4900 LEESBURG PIKE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22302-1103
Practice Address - Country:US
Practice Address - Phone:703-310-6864
Practice Address - Fax:804-597-2156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies