Kaiser Foundation Health Plan Of The Mid Atlantic States, INC
Pharmacy, Managed Care Organization Pharmacy in Halethorpe, MD. Organization (NPI-2).
NPI number1124366554
StatusActive
Last updated in NPPESJul 24, 2025
Details
- NPI
- 1124366554
- Entity type
- Organization (NPI-2)
- Legal business name
- Kaiser Foundation Health Plan Of The Mid Atlantic States, INC
- Organization subpart
- Yes
- Enumeration date
- Jan 18, 2013
- Certification date
- Jul 24, 2025
- Last updated
- Jul 24, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336M0003X | Pharmacy, Managed Care Organization Pharmacy | – | – | Yes |
Other names
- Kaiser Permanente South Baltimore County Pharmacy (Doing Business As)
Practice location
1701 Twin Springs RdHalethorpe, MD 21227-3553
Phone 410-737-5200 · Fax 410-737-5201
Mailing address
4000 Garden City DrHyattsville, MD 20785-2418
Phone 301-816-2424
Authorized official
Colleen Swinton
Director, Credentialing
3012572797
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