Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER PERMANENTE PHARMACY #888
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
309 W VENTURA BLVD, STE B, CAMARILLO, CA 93010-8376
(877) 214-7840
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
PHY48588
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1720261282
—
CA
01
—
5628790
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/07/2007
Last updated
03/04/2024
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