Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER ONCOLOGY PHARMACY #573
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
4501 SAND CREEK RD FL 4, ANTIOCH, CA 94531-8687
(925) 813-3958
Mailing address
1800 HARRISON ST FL 13, OAKLAND, CA 94612-3466
(925) 813-3958
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY48612
CA
3336C0004X
Compounding Pharmacy
Primary
PHY48612
CA
Other
Enumeration date
06/16/2009
Last updated
10/20/2020
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