Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER PERMANENTE PHARMACY #514
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN RENOUARD BROWN (VP PHARMACY OPERATIONS AND SERVICES)
(510) 625-2363
Entity
Organization
Contact information
Practice address
1425 S MAIN ST, 2ND FL, WALNUT CREEK, CA 94596-5318
(925) 295-5438
(925) 295-6779
Mailing address
1800 HARRISON ST FL 13, OAKLAND, CA 94612-3466
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHY46988
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5624920
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/29/2006
Last updated
10/20/2020
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