Healthcare Provider Details

I. General information

NPI: 1275886418
Provider Name (Legal Business Name): INOVA HEALTH CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2012
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MAPLE AVE E
VIENNA VA
22180-5723
US

IV. Provider business mailing address

PO BOX 37174
BALTIMORE MD
21297-3174
US

V. Phone/Fax

Practice location:
  • Phone: 703-938-5300
  • Fax:
Mailing address:
  • Phone: 571-423-5699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALICE POPE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 703-289-2048