KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.; NPI #1245567783

Contact Information

KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.

2400 MOUNT ZION PKWY
JONESBORO, GA 30236-2500

Phone: 770-603-3847
Fax: 770-603-3561
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Managed Care Organization Pharmacy	3336M0003X	58	Medical Supply Company with Pharmacist

Indicates primary specialty

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

NPI # 1245567783

LBN Legal business name KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.

Authorized official DIANE SANDERS - (PHARMACY COMPLIANCE MANAGER)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/04/2009

Last updated 08/04/2021 - About 5 years ago

Identifiers

GA	License #	PHCL000019
	Other	2122375	PK

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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