KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC NPI 1417214925

NPI Information

NPI: 1417214925
Provider Name: KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC

Doing Business As: KAISER PERMANENTE TOWNPARK CLINIC PHARMACY

Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

Address:
750 TOWNPARK LN NW
KENNESAW, GA
ZIP 30144
Phone: (770) 514-5636
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KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC is a clinic pharmacy pharmacy in Kennesaw, GA. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC NPI is 1417214925. The provider is registered as an organization entity type.
The provider Is Doing Business As Kaiser Permanente Townpark Clinic Pharmacy.

The provider's business location address is:

750 TOWNPARK LN NW
KENNESAW, GA
ZIP 30144-579
Phone: (770) 514-5636
Fax: (770) 794-4009

The provider's authorized official is Diane Sanders .
The authorized official title is Pharmacy Compliance Manager and has the following contact phone number (770) 712-5654.

The enumeration date for this NPI number is 4/20/2012 and was last updated on 8/4/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3336C0002X	Pharmacy	Clinic Pharmacy	PHCL000017	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1162306	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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