Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #971
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
501 J ST FL 1, SACRAMENTO, CA 95814-2325
(916) 497-4250
(916) 497-4255
Mailing address
1800 HARRISON ST FL 13, OAKLAND, CA 94612-3466
(916) 497-4250
(916) 497-4255
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY56090
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497259956
—
CA
01
—
2176901
PK
—
01
—
5666170
NCPDP
—
Enumeration date
03/20/2018
Last updated
10/23/2020
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