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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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Managed Care Organization Pharmacy |
3336M0003X | 58 | Medical Supply Company with Pharmacist |
| NPI # | 1093757809 |
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| LBN Legal business name | KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. | ||||||||
| Authorized official | DIANE SANDERS - (PHCY COMPLIANCE MGR) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 06/13/2006 | ||||||||
| Last updated | 08/04/2021 - About 5 years ago | ||||||||
| Identifiers |
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KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.