Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER PERMANENTE PHARMACY NO 672
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT CARVER (VP PHRMCY STRATEGY OPERATIONS)
(562) 658-3510
Entity
Organization
Contact information
Practice address
3700 VACA VALLEY PKWY FL 2, VACAVILLE, CA 95688-9430
(707) 453-5202
(707) 453-2959
Mailing address
3700 VACA VALLEY PKWY FL 2, VACAVILLE, CA 95688-9430
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY46045
CA
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0585729
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHA460450
—
CA
Enumeration date
01/08/2007
Last updated
05/20/2010
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