KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.; NPI #1568577450

Contact Information

KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.

1745 PEACHTREE RD NE
ATLANTA, GA 30309-2410

Phone: 404-888-7656
Fax: 404-888-7661
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 Number 1568577450

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 08/20/2006

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

Identifiers

GA	License #	PHRE008700
	Other	1150680	NCPDP PROVIDER IDENTIFICATION 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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