Provider Demographics
NPI:1528472792
Name:INNOVATUS CARE, LLC
Entity type:Organization
Organization Name:INNOVATUS CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGO
Authorized Official - Middle Name:
Authorized Official - Last Name:DINKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-411-2119
Mailing Address - Street 1:4020 PLANK RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-4800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4020 PLANK RD
Practice Address - Street 2:SUITE B
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-4800
Practice Address - Country:US
Practice Address - Phone:855-411-2110
Practice Address - Fax:855-411-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO-141141253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care