Organization Name: | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC |
NPI Number: | 1124366554 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEANNE G PETERSEN (CHIEF FINANCIAL OFFICER) |
Mailing Address: | 1701 Twin Springs Rd Halethorpe |
State: | MD US |
Postal Code: | 212273553 |
Phone Number: | 4107375200 |
Fax Number: | 4107375201 |
NPI Enumeration Date: | 01/18/2013 |
NPI Last Update Date: | 12/23/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3336M0003X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | Managed Care Organization Pharmacy |
Taxonomy Definition: | A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO |