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KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATESINC NPI 1811031743


NPI Information

NPI: 1811031743
Provider Name: KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC

Doing Business As: ASHBURN MEDICAL CENTER PHARMACY

Classification: Pharmacy - 3336M0003X
Entity Type: Organization

Specialization: Managed Care Organization Pharmacy

Address:
43480 YUKON DR
STE 100
ASHBURN, VA
ZIP 20147
Phone: (703) 227-5006
Get Directions

KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC is a managed care organization pharmacy pharmacy in Ashburn, VA. The provider is 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. KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES,INC NPI is 1811031743. The provider is registered as an organization entity type.
The provider Is Doing Business As Ashburn Medical Center Pharmacy.

The provider's business location address is:

43480 YUKON DR
STE 100
ASHBURN, VA
ZIP 20147-988
Phone: (703) 227-5006

The provider's authorized official is Deanne G Petersen .
The authorized official title is Chief Financial Officer and has the following contact phone number (301) 816-5760.

The enumeration date for this NPI number is 2/16/2007 and was last updated on 5/27/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336M0003XPharmacyManaged Care Organization Pharmacy0201004121VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14839669OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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