Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER 2 REFILL WC PHARMACY 602
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM PERRY FLOWERS (VP ACUTE TRANSITIONAL CARE)
(562) 658-3671
Entity
Organization
Contact information
Practice address
6600 BRUCEVILLE RD, SACRAMENTO, CA 95823
(916) 688-2857
(916) 688-2251
Mailing address
12254 BELLFLOWER BLVD FL 2, PHARMACY PROFESSIONAL AFFAIRS, DOWNEY, CA 90242-2804
(562) 658-3671
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY36725
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0565486
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHB367250
—
CA
Enumeration date
01/08/2007
Last updated
06/01/2018
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