Organization
KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Active
Other names
Kaiser Permanente
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE SANDERS (PHARMACY COMPLIANCE MANAGER)
(770) 712-5654
Entity
Organization
Contact information
Practice address
3650 STEVE REYNOLDS BLVD, DULUTH, GA 30096-4506
(770) 931-6362
(770) 931-6360
Mailing address
3650 STEVE REYNOLDS BLVD, DULUTH, GA 30096-4506
(770) 931-6362
(770) 931-6360
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHCL000016
GA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2118693
PK
—
Enumeration date
02/12/2009
Last updated
08/04/2021
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