Organization · Type 2 NPI

Kaiser Foundation Health Plan of Georgia, Inc.

Managed Care Organization Pharmacy · Mcdonough, GA

NPI number 1487697264 Active

Practice location

1125 Town Center Village Dr
Mcdonough, GA 30253-5970

Fax (678) 583-6563

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	None listed
Managed Care Organization Pharmacy Primary	3336M0003X	PHRE008647 (GA)

Managed Care Organization Pharmacy: A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO's covered members only.

9 other providers at this address

NPI record

NPI: 1487697264
Entity type: Organization (Type 2)
Issued: Jun 13, 2006
Last updated: Aug 4, 2021
Status: Active

Other names

<unavail>
Kaiser Permanente Henry · doing business as
Kaiser Permanente Henry · doing business as

Authorized official

Diane Sanders
Phcy Compliance MGR
(770) 712-5654

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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 1487697264

Kaiser Foundation Health Plan of Georgia, Inc.'s National Provider Identifier is 1487697264, issued on Jun 13, 2006. The primary taxonomy on file is Managed Care Organization Pharmacy (3336M0003X), and the practice location is in Mcdonough, GA. The record was last updated on Aug 4, 2021.