KAISER PERMANENTE FREDERICK MED CTR (NPI# 1477618502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477618502 |
| Entity Type | Organization |
| Organization Name | KAISER PERMANENTE FREDERICK MED CTR |
| Practice Address |
7190 Crestwood Blvd Frederick MD 21703 |
| Practice Telephone | 2405291800 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MICHELLE BONSTALLI (LEAD PHARMACIST) |
| Authorized Official Telephone | 2405291800 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2133229 | 01 |
| Street Address |
7190 CRESTWOOD BLVD |
| City | FREDERICK |
| State | MD |
| Zip Code | 21703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548347065 | Susan K Lovich | Pediatrics | 7190 Crestwood Blvd, Kaiser Permanente Frederick Medical Center, Frederick, MD 21703-7314 | 2006-11-01 |
| 1245573427 | Sarah Kang-pak | Pharmacist | 7190 Crestwood Blvd, Frederick, MD 21703-7314 | 2013-04-05 |
| 1760723555 | Ann Louise Hallock | Pharmacist | 7190 Crestwood Blvd, Frederick, MD 21703-7314 | 2013-03-05 |
| 1972844702 | Diana Erin Mcdermott | Pharmacist | 7190 Crestwood Blvd, Frederick, MD 21703-7314 | 2013-03-04 |
| 1609010271 | Sokpheary Srorn | Family Medicine | 7190 Crestwood Blvd, Kaiser Permanente Frederick Medical Center, Frederick, MD 21703-7314 | 2009-04-27 |
| 1972762995 | Laine Montgomery Cornelison | Family Medicine | 7190 Crestwood Blvd, Kaiser Permanente Frederick Medical Center, Frederick, MD 21703-7314 | 2008-06-05 |
| 1003008830 | Paula Grace | Social Worker | 7190 Crestwood Blvd, Kaiser Permanente Frederick Medical Center, Frederick, MD 21703-7314 | 2007-08-15 |
| 1437272150 | Kimberly Dawn Wagner | Pharmacist | 7190 Crestwood Blvd, Frederick, MD 21703-7314 | 2007-04-09 |
| 1194868422 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 7190 Crestwood Blvd, Frederick, MD 21703-7314 | 2007-02-15 |
| 1407999527 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 7190 Crestwood Blvd, Frederick, MD 21703-7314 | 2007-02-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861902959 | Kenny Chen | Optometrist | 5283 Corporate Dr Ste 201, Frederick, MD 21703 | 2017-10-03 |
| 1578934550 | Barbara Tarlowski | Physical Therapy Assistant | 347 Ballenger Center Drive, Frederick, MD 21703 | 2015-10-15 |
| 1679958813 | Taiji Acupuncture Clinic | Community Based Residential Treatment Facility, Mental Illness | 1411 Bluewing Ct, Frederick, MD 21703 | 2015-07-29 |
| 1609283050 | Green Ridge Behavioral Health, LLC | Psychiatry & Neurology | 5216 Chairmans Court, Suite 102, Frederick, MD 21703 | 2014-07-17 |
| 1841597705 | Jennifer Anne Dye | Speech-Language Pathologist | 5312 Ballenger Creek Pike, Frederick, MD 21703 | 2011-02-11 |
| 1568794790 | Andersons Community Healthcare Services Inc | Nursing Care | 4727 Verdana Loop, Frederick, MD 21703 | 2010-02-15 |
| 1962672782 | Service Coordination Inc | Case Management | 5303 Spectrum Drive, Suite I, Frederick, MD 21703 | 2008-03-07 |
| 1396877189 | Health and Happiness LLC | Psychologist | 93 S Mccain Drive, Frederick, MD 21703 | 2007-03-09 |
| 1275629776 | Mary Bernadette Sheehy | Nurse Practitioner | Fmh Wellness Center 5500 Buckeystown Pike, Corpohs Prospect Plaza, Frederick, MD 21703 | 2006-10-04 |
| 1720185218 | Rea and Derick Inc P 1835 | Pharmacy | 5500 Buckeystown Pk Frcs Sct Key Mall, Frederick, MD 21703 | 2006-09-19 |
| Find all providers in zip 21703 | ||||
| Taxonomy Code | 3336M0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Managed Care Organization Pharmacy |
| A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO’s covered members only. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194868422 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 7190 Crestwood Blvd, Frederick, MD 21703-7314 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679888655 | Zonetak Healthcare And | Pharmacy | 10085 Red Run Blvd Ste 104, Owings Mills, MD 21117-4811 | 2010-08-13 |
| 1710045299 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 655 Watkins Mill Road, Gaithersburg, MD 20879-3323 | 2006-12-05 |
| 1215002258 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 7141 Security Boulevard, Baltimore, MD 21244-1811 | 2006-11-22 |
| 1033658521 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 7670 Quarterfield Rd, Glen Burnie, MD 21061-3947 | 2017-02-16 |
| 1083153696 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 3400 Box Hill Corporate Center Dr, Ste 100, Abingdon, MD 21009-1261 | 2017-02-15 |
| 1124366554 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 1701 Twin Springs Rd, Halethorpe, MD 21227-3553 | 2013-01-18 |
| 1518025071 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 4920 Campbell Boulevard, White Marsh, MD 21236-5916 | 2006-12-05 |
| 1871651349 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 1396 Piccard Drive, Rockville, MD 20850-4302 | 2006-12-05 |
| 1609934181 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 10810 Connecticut Avenue, Kensington, MD 20895-2138 | 2006-12-05 |
| 1801954375 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 1447 York Road, Suite 100, Lutherville, MD 21093-6014 | 2006-12-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.