Organization · Type 2 NPI

Kaiser Foundation Health Plan of Georgia, Inc.

Managed Care Organization Pharmacy · Holly Springs, GA

NPI number 1881910552 Active

Practice location

684 Sixes Rd Ste 275
Holly Springs, GA 30115-8721

Fax (770) 852-2441

Specialties and licenses

Taxonomy	Code	License
Managed Care Organization Pharmacy Primary	3336M0003X	PHRE009659 (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.

2 other providers at this address

NPI record

NPI: 1881910552
Entity type: Organization (Type 2)
Issued: Apr 20, 2010
Last updated: Aug 4, 2021
Status: Active

Other names

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Kaiser Permanente Holly Springs · doing business as
Kaiser Permanente Holly Springs · doing business as

Authorized official

Ms. Diane Sanders
Pharmacy Compliance Manager
(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 1881910552

Kaiser Foundation Health Plan of Georgia, Inc.'s National Provider Identifier is 1881910552, issued on Apr 20, 2010. The primary taxonomy on file is Managed Care Organization Pharmacy (3336M0003X), and the practice location is in Holly Springs, GA. The record was last updated on Aug 4, 2021.