Healthcare Provider Details

I. General information

NPI: 1609718089
Provider Name (Legal Business Name): INOVA HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 TANEY AVE STE 103
FREDERICK MD
21702-5126
US

IV. Provider business mailing address

PO BOX 37174
BALTIMORE MD
21297-3174
US

V. Phone/Fax

Practice location:
  • Phone: 301-424-8484
  • Fax: 301-424-1835
Mailing address:
  • Phone: 571-423-5699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: RICK TALENTO
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CFO
Phone: 571-472-8717