Organization
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Active
Other names
Kaiser Permanente Largo Infusion Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
COLLEEN SWINTON (CREDENTIALING DIRECTOR)
(301) 257-2797
Entity
Organization
Contact information
Practice address
1221 MERCANTILE LN, LARGO, MD 20774-5374
(301) 618-5880
(301) 618-5912
Mailing address
4000 GARDEN CITY DR, HYATTSVILLE, MD 20785-2418
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PW0335
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2123905
PK
—
Enumeration date
02/19/2010
Last updated
07/24/2025
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