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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 # | 1699084046 |
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| LBN Legal business name | KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC | ||||
| Authorized official | COLLEEN SWINTON - (DIRECTOR, CREDENTIALING) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | Yes | ||||
| Enumeration date | 10/04/2010 | ||||
| Last updated | 07/25/2025 - About 10 months ago | ||||
| Identifiers |
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KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC