Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER SIERRA GARDENS PHARMACY 593
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
1840 SIERRA GARDENS DR, ROSEVILLE, CA 95661-2912
(916) 784-6485
(916) 784-4525
Mailing address
1800 HARRISON ST FL 13, OAKLAND, CA 94612-3466
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY36586
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0565424
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
PHB365860
—
CA
Enumeration date
01/08/2007
Last updated
10/23/2020
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