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General NPI Number Information
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NPI Number | 1841632593
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Entity Type | Organization
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Legal Business Name | INOVA HEALTH CARE SERVICES
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 09/21/2020
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Provider Practice Location Address
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Address Line | 3600 JOSEPH SIEWICK DR
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City | FAIRFAX
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State | VA
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Zip | 22033-1709
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Country | US
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Telephone | 703-391-3640
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Fax |
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Provider Business Mailing Address
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Address Line | 3600 JOSEPH SIEWICK DR
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City | FAIRFAX
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State | VA
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Zip | 22033-1709
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Country | US
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Telephone | 703-391-3080
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Fax | 703-391-4064
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Authorized Official
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Title or Position | DIRECTOR OF RETAL AND SPECIALTY
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Name | DEBRA BROOKS
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Credential |
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Telephone | 571-472-1898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 0201004529
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License Number State | VA
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