Kaiser Permanente Phy #193

LBN: Kaiser Foundation Health Plan Inc
Kaiser Permanente Phy #193 is an health care organization with primary practice located at 17296 Slover Ave Palm Court 1, Fontana CA 92337-7585. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Compounding Pharmacy, Suppliers / Home Infusion Therapy Pharmacy. Suppliers / Home Infusion Therapy Pharmacy is the primary health care specialty. Kaiser Foundation Health Plan Inc can be contacted via phone (909) 609-3360, or through Polchak, Rhonda Lee via phone (562) 658-3510.

Contact Information

Primary practice address
17296 Slover Ave Palm Court 1 Fontana CA 92337-7585
Phone: (909) 609-3360
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Polchak, Rhonda Lee
Phone: (562) 658-3510

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Compounding Pharmacy 3336C0004X
Suppliers / Home Infusion Therapy Pharmacy 3336H0001X PHY48828 California

Profile Details

NPI number 1922281906
LBN Legal business name Kaiser Foundation Health Plan Inc
DBA Doing business as Kaiser Permanente Phy #193
Authorized official Polchak, Rhonda Lee
Entity Organization
Organization subpart 1 No
Enumeration date Dec 12th, 2007
Last updated Jun 12th, 2023 - about 3 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 1922281906 NPPES
Other 5628827 NCPDP PROVIDER IDENTIFICATION NUMBER

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