National Provider Identifier Database

KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC
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.


Contact Information

KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
2505 DALLAS HWY SW
MARIETTA, GA30064-2659
Phone: 770-792-2010
Fax: 770-792-2003
Website:
Specialty Taxonomy Code
* Managed Care Organization Pharmacy 3336M0003X
Pharmacy 333600000X

* Indicates primary specialty

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

NPI Number 1063733210
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 06/22/2010
Last updated 07/10/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: PHRE009685
  • Other: 2125368 PK

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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