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Organization

KAISER FOUNDATION HEALTH PLAN INC

Active
Other names
KAISER PERMANENTE PHARMACY #336
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
1550 W MANCHESTER AVE FL 1, LOS ANGELES, CA 90047-5424
(866) 352-9934
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
PHY50445
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1801196894
CA
01
5639488
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
10/25/2010
Last updated
06/12/2023
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