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KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES INC. NPI 1578120747


NPI Information

NPI: 1578120747
Provider Name: KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC.

Doing Business As: KAISER PERMANENTE HAYMARKET CROSSROADS PHARMACY

Classification: Pharmacy - 3336M0003X
Entity Type: Organization

Specialization: Managed Care Organization Pharmacy

CLIA Number: 49D2167706

Address:
15050 HEATHCOTE BLVD
HAYMARKET, VA
ZIP 20169
Phone: (571) 455-7300
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KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC. is a managed care organization pharmacy pharmacy in Haymarket, 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 1578120747. The provider is registered as an organization entity type.
The provider Is Doing Business As Kaiser Permanente Haymarket Crossroads Pharmacy.

The provider's business location address is:

15050 HEATHCOTE BLVD
HAYMARKET, VA
ZIP 20169-251
Phone: (571) 455-7300
Fax: (571) 455-7301

The provider's authorized official is Joseph T Butz .
The authorized official title is Chief Operating Officer and has the following contact phone number (301) 816-5867.

The CLIA number assigned to this NPI record is 49D2167706 - health main. organization with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/23/2019 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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336M0003XPharmacyManaged Care Organization PharmacyYes

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: 5/5/2024

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