Organization · Type 2 NPI

Kaiser Foundation Health Plan of Georgia, Inc.

Managed Care Organization Pharmacy · Atlanta, GA

NPI number 1811321763 Active

Practice location

1100 Lake Hearn Dr Ste 500
Atlanta, GA 30342-1548

Fax (404) 845-4531

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	None listed
Community/Retail Pharmacy	3336C0003X	None listed
Managed Care Organization Pharmacy Primary	3336M0003X	PHRE009952 (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.

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NPI record

NPI: 1811321763
Entity type: Organization (Type 2)
Issued: Aug 28, 2013
Last updated: Aug 4, 2021
Status: Active

Other names

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Kaiser Permanente Sandy Springs · doing business as
Kaiser Permanente Sandy Springs · doing business as

Authorized official

Diane Sanders
Pharmacy Compliance Manager
(404) 949-5336

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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 1811321763

Kaiser Foundation Health Plan of Georgia, Inc.'s National Provider Identifier is 1811321763, issued on Aug 28, 2013. The primary taxonomy on file is Managed Care Organization Pharmacy (3336M0003X), and the practice location is in Atlanta, GA. The record was last updated on Aug 4, 2021.