Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #339
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
1000 FRANKLIN PKWY, FLOOR 1, SAN MATEO, CA 94403-1922
(650) 299-2809
Mailing address
1800 HARRISON ST FL 13, OAKLAND, CA 94612-3466
(650) 299-2809
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY50626
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487944492
—
CA
01
—
5640708
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/11/2011
Last updated
11/24/2020
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