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
Ashburn Medical Center Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC
Authorized official
COLLEEN SWINTON (CREDENTIALING DIRECTOR)
(301) 257-2797
Entity
Organization
Contact information
Practice address
43480 YUKON DR, STE 100, ASHBURN, VA 20147-6988
(703) 227-5006
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
0201004121
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4839669
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/16/2007
Last updated
10/10/2025
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