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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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Managed Care Organization Pharmacy |
3336M0003X | 58 | Medical Supply Company with Pharmacist |
| NPI Number | 1477016368 |
| LBN Legal business name | KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC |
| Authorized official | COLLEEN SWINTON - (CREDENTIALING DIRECTOR) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 04/09/2019 |
| Last updated | 07/24/2025 - About 11 months ago |
| Identifiers | n/a |
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KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC