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
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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