Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #922
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
2500 MERCED ST, 2ND FL RM 2966, SAN LEANDRO, CA 94577-4201
(510) 454-2747
Mailing address
1800 HARRISON ST FL 13, OAKLAND, CA 94612-3466
(510) 454-2747
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
PHY51911
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146111
PK
—
Enumeration date
06/03/2014
Last updated
10/21/2020
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