National Provider Identifier Database

KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Contact Information

KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
1478 DOGWOOD DR SE
CONYERS, GA30013-5088
Phone: 678-413-4321
Fax: 678-413-4323
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Managed Care Organization Pharmacy 3336M0003X

* Indicates primary specialty

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

NPI Number 1174826754
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 12/21/2010
Last updated 08/04/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: PHRE009716
  • Other: 1160756 NCPDP PROVIDER IDENTIFICATION NUMBER

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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