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NPI Code Detail

MEDICARE: KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC

MEDICARE: KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336H0001XHome Infusion Therapy Pharmacy

General Provider Information

NPI Number : 1538819925
Entity Type Code : Organization
Provider Name (Legal Business Name) : KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Provider Business Mailing Address
First Line : 4000 GARDEN CITY DR
Second Line :
City : HYATTSVILLE
State : MD
Zip : 20785-2418
Country : US
Telephone Number : 301-816-2424
Fax Number :
Provider Business Practice Location Address
First Line : 13285 MINNIEVILLE RD
Second Line :
City : WOODBRIDGE
State : VA
Zip : 22192-4018
Country : US
Telephone Number : 301-816-2424
Fax Number :
Authorized Official
Title or Position : CREDENTIALING DIRECTOR
Name : COLLEEN E SWINTON
Credential :
Telephone Number : 301-257-2729
Provider Enumeration Date : 03/28/2022
Last Update Date : 07/24/2025

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