Organization · Type 2 NPI

Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

Managed Care Organization Pharmacy · Manassas, VA

NPI number 1801954300 Active

Practice location

10701 Rosemary Dr
Manassas, VA 20109-2843

Call (703) 257-3056 Map

Fax (703) 257-3133

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.

29 other providers at this address

NPI record

NPI: 1801954300
Entity type: Organization (Type 2)
Issued: Dec 5, 2006
Last updated: Oct 10, 2025
Status: Active
Subpart: Yes of Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc

Other names

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Manassas Medical Center Pharmacy · doing business as
Manassas Medical Center Pharmacy · doing business as

Authorized official

Colleen Swinton
Credentialing Director
(301) 257-2797

Verify this record

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 1801954300

Kaiser Foundation Health Plan of the Mid Atlantic States, Inc's National Provider Identifier is 1801954300, issued on Dec 5, 2006. The primary taxonomy on file is Managed Care Organization Pharmacy (3336M0003X), and the practice location is in Manassas, VA. The record was last updated on Oct 10, 2025.