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Organization
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Active
Organization
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN SWINTON (CREDENTIALING DIRECTOR)
(301) 257-2729
Entity
Organization
Contact information
Practice address
7190 CRESTWOOD BLVD, FREDERICK, MD 21703
(240) 529-1800
Mailing address
4000 GARDEN CITY DR, HYATTSVILLE, MD 20785-2418
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
3336M0003X
Managed Care Organization Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133229
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
12/27/2006
Last updated
07/24/2025
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