Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #122
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
25821 VERMONT AVE, FL 1, HARBOR CITY, CA 90710-3518
(844) 424-1866
Mailing address
12254 BELLFLOWER BLVD FL 2, PHARMACY OPERATIONS, DOWNEY, CA 90242-2804
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY51848
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104244490
—
CA
01
—
2145571
PK
—
01
—
5651268
NCPDP
CA
Enumeration date
04/03/2014
Last updated
07/05/2023
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