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Organization

KAISER FOUNDATION HEALTH PLAN INC

Active
Other names
KAISER POINT WEST MAIN PHARMACY 626
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
1650 RESPONSE RD, SACRAMENTO, CA 95815-4807
(916) 614-4565
(916) 614-4566
Mailing address
1800 HARRISON ST FL 13, OAKLAND, CA 94612-3466

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY43320
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0576566
NCPDP PROVIDER IDENTIFICATION NUMBER
05
PHA433200
CA
Enumeration date
01/08/2007
Last updated
10/23/2020
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