Organization
KAISER FOUNDATION HOSPITALS
Active
Other names
KAISER PERMANENTE PHARMACY NO 166
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT CARVER (VP PHRMCY STRATEGY OPERATIONS)
(562) 658-3510
Entity
Organization
Contact information
Practice address
39400 PASEO PADRE PKWY, FREMONT, CA 94538-2310
(510) 248-7077
(510) 248-7080
Mailing address
39400 PASEO PADRE PKWY, FREMONT, CA 94538-2310
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY46069
CA
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0585236
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA460690
—
CA
Enumeration date
01/05/2007
Last updated
04/28/2021
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