Organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Active
Parent organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Other names
Southwood Home Infusion Retail Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Authorized official
MS. DIANE SANDERS (PHARMACY COMPLIANCE MANAGER)
(770) 712-5654
Entity
Organization
Contact information
Practice address
2400 MOUNT ZION PKWY RM 101A503, JONESBORO, GA 30236-2500
(770) 603-3953
(770) 603-3958
Mailing address
2400 MOUNT ZION PKWY RM 101A503, JONESBORO, GA 30236-2500
(770) 603-3953
(770) 603-3958
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
08/26/2022
Last updated
08/26/2022
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