KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC (NPI# 1124186606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124186606 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC |
| Other Organization Name | SEVERNA PARK MEDICAL CENTER PHARMACY |
| Practice Address |
8028 Richie Highway Suite 134 Pasadena MD 21122-1030 |
| Mailing Address |
22370 Davis Dr Suite 190 Sterling VA 20164-5366 |
| Practice Telephone | 4105532413 |
| Practice Fax Number | 4105532427 |
| 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 |
| 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 |
|---|---|
| Severna Park 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 |
8028 RICHIE HIGHWAY SUITE 134 |
| City | PASADENA |
| State | MD |
| Zip Code | 21122-1030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013082957 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 8028 Richie Highway, Pasadena, MD 21222-1030 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889211 | Hyunji Lee | Pharmacist | 8107 Governor Ritchie Highway, Pasadena, MD 21122 | 2020-10-25 |
| 1538712625 | Liri Fusha | Clinic/Center | 8221 Richie Hwy Suit #102, Pasadena, MD 21122 | 2019-07-18 |
| 1730649922 | Barrett Arthur Tollenger | Counselor | 2825 Mountain Road, Suite 204, Pasadena, MD 21122 | 2019-03-22 |
| 1750849543 | Bradley J Spoon | Counselor | 8028 Ritchie Highway St. 312, Pasadena, MD 21122 | 2019-03-11 |
| 1366916553 | Brittney Byrd | Behavior Technician | 7759 Middlegate Ct, Pasadena, MD 21122 | 2019-01-22 |
| 1780154310 | Amanda Ann Zeller | Speech-Language Pathologist | 8515 Jenkins Road, Pasadena, MD 21122 | 2018-11-27 |
| 1225531544 | Anne Arundel-sca Surgicenter, LLC | Clinic/Center | 8109 Ritchie Hwy Ste 250, Pasadena, MD 21122 | 2018-03-13 |
| 1629577424 | Anne Arundel Physician Group, LLC | Obstetrics & Gynecology | 18 Magothy Beach Road Suite A, Pasadena, MD 21122 | 2018-02-07 |
| 1063968261 | Chinedu Ikpemo | Pharmacist | 8051 Fort Smallwood Rd, Pasadena, MD 21122 | 2016-08-28 |
| 1053728634 | Wisecare, LLC | Clinic/Center | 33 Magothy Beach Rd, Suite 102-103, Pasadena, MD 21122 | 2014-07-16 |
| Find all providers in zip 21122 | ||||
| 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 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.