Organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Active
Other names
Kaiser Permanente Sandy Springs
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE SANDERS (PHARMACY COMPLIANCE MANAGER)
(404) 949-5336
Entity
Organization
Contact information
Practice address
1100 LAKE HEARN DR STE 500, ATLANTA, GA 30342-1548
(404) 845-4530
(404) 845-4531
Mailing address
1100 LAKE HEARN DR STE 500, ATLANTA, GA 30342-1548
(404) 845-4530
(404) 845-4531
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
Primary
PHRE009952
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141469
PK
—
Enumeration date
08/28/2013
Last updated
08/04/2021
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