Organization · Type 2 NPI

Kaiser Foundation Health Plan of Georgia, Inc.

Managed Care Organization Pharmacy · Decatur, GA

NPI number 1699003681 Active

Practice location

201 W Ponce De Leon Ave
Decatur, GA 30030-3217

Fax (404) 687-7730

Specialties and licenses

Taxonomy	Code	License
Managed Care Organization Pharmacy Primary	3336M0003X	PHRE009629 (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.

5 other providers at this address

NPI record

NPI: 1699003681
Entity type: Organization (Type 2)
Issued: Dec 2, 2009
Last updated: Aug 4, 2021
Status: Active

Other names

<unavail>
Kaiser Permanente Decatur Pharmacy · doing business as
Kaiser Permanente Decatur Pharmacy · doing business as

Authorized official

Diane Sanders
Pharmacy Compliance Manager
(404) 949-5336

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.

Is this your record? How to update it.

About NPI 1699003681

Kaiser Foundation Health Plan of Georgia, Inc.'s National Provider Identifier is 1699003681, issued on Dec 2, 2009. The primary taxonomy on file is Managed Care Organization Pharmacy (3336M0003X), and the practice location is in Decatur, GA. The record was last updated on Aug 4, 2021.