Provider Demographics
NPI:1821616046
Name:CORVISTA HEALTH, INC.
Entity Type:Organization
Organization Name:CORVISTA HEALTH, INC.
Other - Org Name:A4L (US), INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BUSINESS OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CLARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-901-0693
Mailing Address - Street 1:3 BETHESDA METRO CTR STE 700
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-6300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 BETHESDA METRO CENTER
Practice Address - Street 2:SUITE 700
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-6300
Practice Address - Country:US
Practice Address - Phone:833-267-8478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-14
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier