Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER HEALTH PLAN SLEEPY HOLLOW PHARMACY143
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
27303 SLEEPY HOLLOW AVE S, HAYWARD, CA 94545-4203
(510) 784-4589
(510) 784-5041
Mailing address
1800 HARRISON ST FL 13, OAKLAND, CA 94612-3466
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY32726
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2028486
PK
—
05
—
PHA327260
—
CA
Enumeration date
01/08/2007
Last updated
09/29/2020
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