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 Shady Grove Peritoneal Dialysis Facility
Organization subpart
Yes
Provider details
NPI number
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC.
Authorized official
COLLEEN SWINTON (DIRECTOR, REGIONAL CREDENTIALING)
(301) 257-2797
Entity
Organization
Contact information
Practice address
1396 PICCARD DR, ROCKVILLE, MD 20850-4302
(301) 548-5700
Mailing address
4000 GARDEN CITY DR, HYATTSVILLE, MD 20785-2418
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Enumeration date
02/02/2023
Last updated
10/10/2025
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