Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
Kaiser Permanente Pharmacy #260
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA LEE POLCHAK (VP PHARMACY OPERATIONS & SVCS, SCAL)
(562) 658-3510
Entity
Organization
Contact information
Practice address
615 W AVENUE L, LANCASTER, CA 93534-7211
(844) 824-6474
Mailing address
12254 BELLFLOWER BLVD FL 2, PHARMACY OPERATIONS, DOWNEY, CA 90242-2804
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY51974
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649689175
—
CA
01
—
2147323
PK
—
01
—
5652525
NCPDP
CA
Enumeration date
08/08/2014
Last updated
06/02/2023
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