Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER PERMANENTE PHARMACY #102
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
3701 BROADWAY FL 1, OAKLAND, CA 94611-5613
(510) 752-4188
Mailing address
1800 HARRISON ST FL 13, OAKLAND, CA 94612-3466
(510) 752-4188
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY 49853
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770723645
—
CA
01
—
5633979
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/04/2009
Last updated
10/20/2020
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up