National Provider Identifier Database

KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC
Clinic Pharmacy

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.


Contact Information

KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC
3650 STEVE REYNOLDS BLVD
DULUTH, GA30096-4506
Phone: 770-931-6188
Fax: 770-931-6375
Website:
Specialty Taxonomy Code
* Clinic Pharmacy 3336C0002X

* Indicates primary specialty

NPI Profile & details for KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC

NPI Number 1508123811
Legal business name
LBN
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC
Authorized official DIANE SANDERS - (PHARMACY COMPLIANCE MANAGER)
Entity Organization
Organization subpart No
Enumeration date 04/12/2012
Last updated 08/04/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: PHCL000015
  • Other: 1162255 NCPDP PROVIDER IDENTIFICATION NUMBER

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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