Organization · Type 2 NPI

Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

Managed Care Organization Pharmacy · Stafford, VA

NPI number 1477016368 Active

Practice location

125 Hospital Center Blvd Ste 110
Stafford, VA 22554-6202

Call (540) 602-6300 Map

Fax (540) 602-6302

Mailing address

4000 Garden City Dr
Hyattsville, MD 20785-2418

Specialties and licenses

Taxonomy	Code	License
Managed Care Organization Pharmacy Primary	3336M0003X	None listed

Managed Care Organization Pharmacy: 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.

5 other providers at this address

NPI record

NPI: 1477016368
Entity type: Organization (Type 2)
Issued: Apr 9, 2019
Last updated: Jul 24, 2025
Status: Active
Subpart: Yes of Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

Other names

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Kaiser Permanente Colonial Forge Pharmacy · doing business as
Kaiser Permanente Colonial Forge Pharmacy · doing business as

Authorized official

Colleen E Swinton
Credentialing Director
(301) 257-2797

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1477016368

Kaiser Foundation Health Plan of the Mid Atlantic States, Inc's National Provider Identifier is 1477016368, issued on Apr 9, 2019. The primary taxonomy on file is Managed Care Organization Pharmacy (3336M0003X), and the practice location is in Stafford, VA. The record was last updated on Jul 24, 2025.