KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC (NPI# 1124366554) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124366554 |
| Entity Type | Organization |
| Organization Name | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC |
| Other Organization Name | KAISER PERMANENTE SOUTH BALTIMORE COUNTY PHARMACY |
| Practice Address |
1701 Twin Springs Rd Halethorpe MD 21227-3553 |
| Mailing Address |
22370 Davis Dr Suite 190 Sterling VA 20164-5367 |
| Practice Telephone | 4107375200 |
| Practice Fax Number | 4107375201 |
| Mailing Telephone | 7034664800 |
| Mailing Fax Number | 7034664802 |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2013-12-23 |
| 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 |
|---|---|
| Kaiser Permanente South Baltimore County Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265971873 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Health Maintenance Organization | 3400 Box Hill Corporate Center Dr, Stes 100 & 200, Abingdon, MD 21009-9998 | 2017-02-15 |
| 1043378656 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Psychologist | 10 Hopkins Plaza, Baltimore, MD 21201-2902 | 2006-12-05 |
| 1740355684 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 815 E Pratt St, Baltimore, MD 21202-4402 | 2006-11-22 |
| 1902971849 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 1396 Piccard Drive, Rockville, MD 20850-4302 | 2006-11-22 |
| 1497820435 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 6501 Loisdale Road, Springfield, VA 22150-1845 | 2006-11-22 |
| 1013082957 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 8028 Richie Highway, Pasadena, MD 21222-1030 | 2006-11-22 |
| 1346315280 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 4920 Campbell Boulevard, Baltimore, MD 21236-5916 | 2006-11-22 |
| 1003981945 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 7070 Samuel Morse Drive, Columbia, MD 21046-3405 | 2006-11-22 |
| 1720153661 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 12201 Plum Orchard Drive, Silver Spring, MD 20910-7803 | 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 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | 1 Kaiser Plz, Oakland, CA 94612-3610 |
| Street Address |
1701 TWIN SPRINGS RD |
| City | HALETHORPE |
| State | MD |
| Zip Code | 21227-3553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629068903 | Ifeoluwa Y Omitowoju | Pediatrics | 1701 Twin Springs Rd, Kaiser Permanente South Baltimore County Hub, Halethorpe, MD 21227-3553 | 2005-10-26 |
| 1689212771 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 1701 Twin Springs Rd, Halethorpe, MD 21227-3553 | 2019-12-19 |
| 1891345674 | Jennifer Fullem | Family Medicine | 1701 Twin Springs Rd, Halethorpe, MD 21227-3553 | 2019-09-13 |
| 1295397305 | Abolanle Busirat Ahmed-orepitan | Family Medicine | 1701 Twin Springs Rd, Halethorpe, MD 21227-3553 | 2019-06-28 |
| 1730743071 | Richard Saunders | Specialist/Technologist, Other | 1701 Twin Springs Rd, Halethorpe, MD 21227-3553 | 2019-04-23 |
| 1245706092 | Thomas Closson | Pharmacist | 1701 Twin Springs Rd, Halethorpe, MD 21227-3553 | 2018-10-19 |
| 1134607765 | Christopher John Miller | Pharmacist | 1701 Twin Springs Rd, Halethorpe, MD 21227-3553 | 2018-08-06 |
| 1053899708 | Kathryn Mundi | Pharmacist | 1701 Twin Springs Rd, Halethorpe, MD 21227-3553 | 2018-08-04 |
| 1174039044 | Antoinette Gupta | Specialist/Technologist, Other | 1701 Twin Springs Rd, Halethorpe, MD 21227-3553 | 2017-12-14 |
| 1568971968 | Andrew Chi | Pharmacist | 1701 Twin Springs Rd, Halethorpe, MD 21227-3553 | 2017-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528622024 | Kim Conaway | Counselor | Regenerations Counseling Services, 1421 S. Canton Street, Baltimore, MD 21227 | 2019-04-30 |
| 1861974891 | Joan Lynn Indilisano | Occupational Therapist | 3320 Benson Avenue, Baltimore, MD 21227 | 2018-09-06 |
| 1821593161 | Institute for Dermatopathology, Inc. | Clinical Medical Laboratory | 1901 Sulphur Spring Rd Ste A, Baltimore, MD 21227 | 2018-03-28 |
| 1447779699 | Aja Williams | Registered Nurse | 3902 Annapolis Rd., Halethorpe, MD 21227 | 2017-09-19 |
| 1588190748 | Mentor-maryland | Community/Behavioral Health | 1540 Caton Center Drive, Halethorpe, MD 21227 | 2017-05-10 |
| 1083084180 | Institute for Family Centered Services | Community/Behavioral Health | 1540 Caton Centered Drive, Suite F, Baltimore, MD 21227 | 2015-10-01 |
| 1174913677 | Wye Oak Clinic, Inc. | Marriage & Family Therapist | 1937 Lansdowne Rd, Halethorpe, MD 21227 | 2015-02-04 |
| 1588938237 | Ahmein Watson | Social Worker | 1504 Joh Ave Ste 120, Baltimore, MD 21227 | 2012-02-28 |
| 1336442656 | Norah Orise Osian | Pharmacist | Rite Aid Pharmacy, 1400 Sulphur Spring Rd, Baltimore, MD 21227 | 2010-12-08 |
| 1366759623 | Een J Lee | Pharmacist | 1400 Sulphurspring Rd, Baltimore, MD 21227 | 2010-09-08 |
| Find all providers in zip 21227 | ||||
| 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 |
| 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 |
| 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 | HALETHORPE |
| Zip Code | 21227 |
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.