Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER PERMANENTE PHARMACY #376
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA LEE POLCHAK (VP NAT'L PHRMCY PROG & SVCS)
(562) 658-3510
Entity
Organization
Contact information
Practice address
4201 W CHAPMAN AVE, ORANGE, CA 92868-1505
(714) 748-6333
(714) 748-6334
Mailing address
4201 W CHAPMAN AVE, ORANGE, CA 92868-1505
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
PHY37644
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5616062
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/08/2007
Last updated
03/04/2024
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