Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER PERMANENTE PHRMCY #041
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
3280 E FOOTHILL BLVD, 1ST FLOOR STE 16, PASADENA, CA 91107-3103
(866) 248-1408
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
PHY49104
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205092582
—
CA
01
—
5631658
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/05/2008
Last updated
06/23/2023
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