Organization
KAISER FOUNDATION HEALTH PLAN INC
Active
Other names
KAISER PERMANENTE PHARMACY #869
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
1100 N PALM CANYON DR, STE 204, PALM SPRINGS, CA 92262-4414
(866) 370-1942
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
PHY53431
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841679065
—
CA
01
—
2152166
PK
—
01
—
5655672
NCPDP
CA
Enumeration date
05/20/2015
Last updated
06/22/2023
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