Organization · Type 2 NPI

Kaiser Foundation Health Plan of Georgia, Inc.

Managed Care Organization Pharmacy · Buford, GA

NPI number 1922295310 Active

Practice location

1435 Broadmoor Blvd
Buford, GA 30518-5408

Fax (678) 765-5682

Specialties and licenses

Taxonomy	Code	License
Managed Care Organization Pharmacy Primary	3336M0003X	PHRE009386 (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.

7 other providers at this address

NPI record

NPI: 1922295310
Entity type: Organization (Type 2)
Issued: Sep 28, 2007
Last updated: Aug 4, 2021
Status: Active

Other names

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Kaiser Permenente Sugar Hill Buford · doing business as
Kaiser Permenente Sugar Hill Buford · 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 1922295310

Kaiser Foundation Health Plan of Georgia, Inc.'s National Provider Identifier is 1922295310, issued on Sep 28, 2007. The primary taxonomy on file is Managed Care Organization Pharmacy (3336M0003X), and the practice location is in Buford, GA. The record was last updated on Aug 4, 2021.