1043563257 NPI number — INOVA HEALTH CARE SERVICES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043563257 NPI number — INOVA HEALTH CARE SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INOVA HEALTH CARE SERVICES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043563257
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8095 INNOVATION PARK DR BLDG D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22031-4868
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-881-1895
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8348 TRAFORD LN STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22152-1650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-569-7335
Provider Business Practice Location Address Fax Number:
703-569-0665
Provider Enumeration Date:
10/25/2012

Additional Information

Authorized Official

Authorized Official Last Name:
TALENTO
Authorized Official First Name:
RICARDO
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
571-472-8717

Provider Taxonomy Codes

  • Taxonomy code: 224Z00000X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0400X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 004979753 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010105064 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010274630 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004980905 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004980921 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004980913 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004979915 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004980875 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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