Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER PERMANENTE PHRMCY #673
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
1 QUALITY DR, SPECIALTY CARE BLDG 1ST FLOOR, VACAVILLE, CA 95688-9494
(707) 624-3050
Mailing address
1800 HARRISON ST FL 13, OAKLAND, CA 94612-3466
(707) 624-3050
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY49103
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689839888
—
CA
01
—
5631090
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/28/2008
Last updated
10/22/2020
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