Organization
KAISER FOUNDATION HOSPITALS
Active
Other names
Kaiser Found Hospital Phrmcy #529
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA LEE POLCHAK (VP PHARMACY OPERATIONS & SVCS, SCAL)
(562) 658-3510
Entity
Organization
Contact information
Practice address
27300 IRIS AVE, MORENO VALLEY, CA 92555-4802
(951) 243-2162
Mailing address
12254 BELLFLOWER BLVD FL 2, PHARMACY OPERATIONS, DOWNEY, CA 90242-2804
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
HSP49011
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5640479
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/14/2008
Last updated
06/01/2023
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