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
—
—
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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