Penderbrook Medical Center

LBN: Kaiser Foundation Health Plan Of The Mid-Atlantic States,Inc
Penderbrook Medical Center is an health care organization with primary practice located at 12011 Lee Jackson Memorial Hwy , Fairfax VA 22033-3310. The organization recently has only one registered license in Managed Care Organizations / Health Maintenance Organization, which is considered as the primary health care specialty. Kaiser Foundation Health Plan Of The Mid-Atlantic States,Inc can be contacted via phone (703) 383-5400, or through Petersen, Andee G. via phone (301) 816-5760.

Contact Information

Primary practice address
12011 Lee Jackson Memorial Hwy Fairfax VA 22033-3310
Phone: (703) 383-5400
Fax: (703) 383-5404
Website:
Map and Directions
Authorized official contact:
Name: Petersen, Andee G. CPA, MBA
Phone: (301) 816-5760

Health care specialties

SpecialtyCodeLicense #State
Managed Care Organizations / Health Maintenance Organization 302R00000X

Profile Details

NPI number 1114048295
LBN Legal business name Kaiser Foundation Health Plan Of The Mid-Atlantic States,Inc
DBA Doing business as Penderbrook Medical Center
Authorized official Petersen, Andee G. CPA, MBA
Entity Organization
Organization subpart 1 Yes
Enumeration date Apr 3rd, 2007
Last updated May 26th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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