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Contact Information

KAISER PERMANENTE INTERNAL
200 CRES CTR PKWY
TUCKER, GA30084-7047
 Phone: 770-496-3623
 Fax: 770-496-3528
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Managed Care Organization Pharmacy

3336M0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for KAISER PERMANENTE INTERNAL

NPI Number 1205872686
LBN Legal business name KAISER PERMANENTE INTERNAL
Authorized official DIANE SANDERS HARVEY - (PHCY COMPLIANCE MGR GA)
Entity Organization
Organization subpart 1 No
Enumeration date 06/22/2006
Last updated 07/19/2007 - About 19 years ago
Identifiers
GA License # 07798
Other 1141023 OTHER ID NUMBER
Other 1141023 OTHER ID NUMBER-COMMERCIAL NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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