Organization · Type 2 NPI

Kaiser Foundation Health Plan Inc

Compounding Pharmacy · San Rafael, CA

NPI number 1093192577 Active

Practice location

99 Montecillo Rd, Bldg 2 FL-5 Rm 5254
San Rafael, CA 94903

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	PHY52494 (CA)
Compounding Pharmacy Primary	3336C0004X	PHY52494 (CA)

Compounding Pharmacy: A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compoun…

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NPI record

NPI: 1093192577
Entity type: Organization (Type 2)
Issued: May 4, 2015
Last updated: Jun 1, 2018
Status: Active
Subpart: Yes of Kaiser Foundation Health Plan Inc

Other names

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Kaiser Permanente Pharmacy #397 · other name
Kaiser Permanente Pharmacy #397 · other name

Authorized official

William Perry Flowers
VP Acute Transitional Care
(562) 658-3510

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1093192577

Kaiser Foundation Health Plan Inc's National Provider Identifier is 1093192577, issued on May 4, 2015. The primary taxonomy on file is Compounding Pharmacy (3336C0004X), and the practice location is in San Rafael, CA. The record was last updated on Jun 1, 2018.