Healthcare Provider Details

I. General information

NPI: 1992262612
Provider Name (Legal Business Name): INOVA HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2019
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 STONECROFT BLVD STE A1400
CHANTILLY VA
20151-1032
US

IV. Provider business mailing address

3901 STONECROFT BLVD STE A1400
CHANTILLY VA
20151-1032
US

V. Phone/Fax

Practice location:
  • Phone: 571-472-1100
  • Fax: 571-472-1101
Mailing address:
  • Phone: 571-472-1100
  • Fax: 571-472-1101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DEBRA BROOKS
Title or Position: DIRECTOR OF RETAIL AND SPECIALTY PH
Credential:
Phone: 571-472-1898