Organization
KAISER FOUNDATION HOSPITALS
Active
Other names
Kaiser Permanente Pharmacy #171
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
2295 S VINEYARD AVE, BLDG B FL-1 RM A1013, ONTARIO, CA 91761-7925
(866) 699-9744
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
PHY46811
CA
3336C0004X
Compounding Pharmacy
Primary
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5613535
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/05/2007
Last updated
06/13/2023
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