Organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Active
Other names
Kaiser Permanente Newnan
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE SANDERS (PHARMACY COMPLIANCE MANAGER)
(770) 712-5654
Entity
Organization
Contact information
Practice address
205 NEWNAN CROSSING BYP, NEWNAN, GA 30265-1063
(770) 304-4410
(770) 304-4402
Mailing address
205 NEWNAN CROSSING BYP, NEWNAN, GA 30265-1063
(770) 304-4410
(770) 304-4402
Taxonomy
Speciality
Code
Description
License number
State
3336M0003X
Managed Care Organization Pharmacy
Primary
PHRE009710
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1160554
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/05/2010
Last updated
08/04/2021
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