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Organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Active
Organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Active
Other names
Kaiser Permanente
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE SANDERS (PHARMACY COMPLIANCE MANAGER)
(770) 712-5654
Entity
Organization
Contact information
Practice address
3650 STEVE REYNOLDS BLVD, DULUTH, GA 30096-4506
(770) 931-6362
(770) 931-6360
Mailing address
3650 STEVE REYNOLDS BLVD, DULUTH, GA 30096-4506
(770) 931-6362
(770) 931-6360
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHCL000016
GA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2118693
PK
—
Enumeration date
02/12/2009
Last updated
08/04/2021
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