Kaiser Health Plan Pharmacy 201

LBN: Kaiser Foundation Health Plan Inc
Kaiser Health Plan Pharmacy 201 is an health care organization with primary practice located at 3900 Lakeville Hwy , Petaluma CA 94954-5698. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Kaiser Foundation Health Plan Inc can be contacted via phone (707) 765-3452, or through Brown, Kathryn Renouard via phone (510) 625-2363.

Contact Information

Primary practice address
3900 Lakeville Hwy Petaluma CA 94954-5698
Fax: (707) 765-3454
Website:
Authorized official contact:
Name: Brown, Kathryn Renouard

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY35387 California

Profile Details

NPI number 1568519882
LBN Legal business name Kaiser Foundation Health Plan Inc
DBA Doing business as Kaiser Health Plan Pharmacy 201
Authorized official Brown, Kathryn Renouard
Entity Organization
Organization subpart 1 No
Enumeration date Jan 5th, 2007
Last updated Nov 24th, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568519882 NPPES
Other 0564838 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID PHA353870 NCPDP PROVIDER IDENTIFICATION NUMBER

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