KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC (NPI# 1518025071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518025071 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC |
| Other Organization Name | WHITE MARSH MEDICAL CENTER PHARMACY |
| Practice Address |
4920 Campbell Boulevard White Marsh MD 21236-5916 |
| Mailing Address |
22370 Davis Dr Suite 190 Sterling VA 20164-5366 |
| Practice Telephone | 4109337626 |
| Mailing Telephone | 7034664800 |
| Mailing Fax Number | 7034664802 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2012-11-13 |
| Authorized Official Name | DEANNE G PETERSEN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3018165760 |
| Authorized Official Credential | CPA MBA |
| Is Organization Subpart | Y |
| Parent Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
Suppliers |
| Other Name | Type Code |
|---|---|
| White Marsh Medical Center Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073953873 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 22370 Davis Dr, Suite 190, Sterling, VA 20164-5367 | 2013-06-26 |
| 1457416000 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 1890 Metro Center Drive, Reston, VA 20190-5276 | 2006-12-26 |
| 1710045299 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 655 Watkins Mill Road, Gaithersburg, MD 20879-3323 | 2006-12-05 |
| 1376601872 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Radiology | 10410 North Kensington Parkway, Kensington, MD 20895-2138 | 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 |
| 1386183713 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Pharmacy | 22370 Davis Dr, Suite 190, Sterling, VA 20164-5367 | 2017-02-17 |
| 1366781700 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Clinic/Center | 1221 Mercantile Ln, Largo, MD 20774-5374 | 2013-02-05 |
| 1942546486 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Clinic/Center | 1701 Twin Springs Rd, Halethorpe, MD 21227-3553 | 2013-01-02 |
| 1104199421 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Clinical Medical Laboratory | 8008 Westpark Dr, Mc Lean, VA 22102-3109 | 2012-02-16 |
| 1245512110 | Kaiser Foundation Health Plan of The Mid-atlantic States,inc | Clinical Medical Laboratory | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3323 | 2011-09-15 |
| Street Address |
4920 CAMPBELL BOULEVARD |
| City | WHITE MARSH |
| State | MD |
| Zip Code | 21236-5916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699381467 | Monique Gaston | Counselor | Well Life Counseling and Consulting, 9649 Belair Road, Ste. 104, Nottingham, MD 21236 | 2020-09-17 |
| 1215575519 | Bh Brightview Perry Hall Opco, LLC | Alzheimer Center (Dementia Center) | 9657 Belair Road, Nottingham, MD 21236 | 2019-12-17 |
| 1750929493 | Bh Brightview White Marsh Opco, LLC | Alzheimer Center (Dementia Center) | 8100 Rossville Blvd., Baltimore, MD 21236 | 2019-12-12 |
| 1083257646 | Matthew Peter Halstad | Behavioral Analyst | 8090 Sandpiper Circle, Nottingham, MD 21236 | 2019-10-25 |
| 1609331602 | Tunisia Buise | Social Worker | 4132 E. Joppa Road Ste. 110-#1248, Baltimore, MD 21236 | 2019-02-04 |
| 1730673047 | Golden Jemz Adult Medical Day | Clinic/Center | 5020 Cambell Blvd, Nottingham, MD 21236 | 2018-06-20 |
| 1487143400 | For Eyes Optical of Pa | Eyewear Supplier (Equipment, not the service) | 7984 Honeygo Blvd, Nottingham, MD 21236 | 2018-05-04 |
| 1619478922 | Weis Markets, Inc. | Pharmacy | 7927 Belair Rd Ste S, Nottingham, MD 21236 | 2018-02-22 |
| 1285133918 | Joan Rosa Keller | Behavior Technician | 3501 Taylor Ave., Baltimore, MD 21236 | 2018-02-08 |
| 1205341146 | Ebony Watkins | Nurse Practitioner | 8940 Kilkenny Circle, Nottingham, MD 21236 | 2017-12-13 |
| Find all providers in zip 21236 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1194868422 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Pharmacy | 7190 Crestwood Blvd, Frederick, MD 21703-7314 | 2007-02-15 |
| 1477618502 | Kaiser Permanente Frederick Med Ctr | Pharmacy | 7190 Crestwood Blvd, Frederick, MD 21703 | 2006-12-27 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | WHITE MARSH |
| Zip Code | 21236 |
Please comment or provide details below to improve the information on KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC.
| 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.