Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Parent organization
KAISER FOUNDATION HEALTH PLAN INC
Other names
Kaiser Permanente Pharmacy #622
Organization subpart
Yes
Provider details
NPI number
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Authorized official
DAVID KVANCZ (VP NAT'L PHRMCY PROG & SVCS)
(562) 658-3510
Entity
Organization
Contact information
Practice address
2025 MORSE AVE, FL 3, RM 3860 & 3861, SACRAMENTO, CA 95825-2115
(916) 973-5945
Mailing address
2025 MORSE AVE, FL 3, RM 3860 & 3861, SACRAMENTO, CA 95825-2115
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY54162
CA
3336C0004X
Compounding Pharmacy
Primary
PHY54162
CA
Other
Enumeration date
02/17/2016
Last updated
02/17/2016
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