Organization
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Active
Organization
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Active
Parent organization
KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC
Other names
Kaiser Permanente Fredericksburg Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC
Authorized official
COLLEEN E SWINTON (CREDENTIALING DIRECTOR)
(301) 257-2797
Entity
Organization
Contact information
Practice address
1201 HOSPITAL DR, FREDERICKSBURG, VA 22401-8428
(540) 368-3800
Mailing address
4000 GARDEN CITY DR, HYATTSVILLE, MD 20785-2418
(301) 257-2797
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
Primary
0201004261
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4841222
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/24/2008
Last updated
07/25/2025
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