NPIMap

Organization Active NPI

Kaiser Permanente Pharmacy

  • Health Maintenance Organization
  • Upland, CA
National Provider Identifier
1114467883
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
36910 Issued in CA
Legal business name
KAISER PERMANENTE PHARMACY
Practice address
1183 E Foothill Blvd
First Floor
Upland, CA 91786-4079
Phone
(909) 367-7080
Fax
(909) 367-7076
NPI assigned
Mar 1, 2017
Last updated
Mar 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eugenia Ellis, PHARMD
Title
Pharmacy Supervisor
Phone
(909) 367-7080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 36910 CA Primary

Addresses

Primary practice location

1183 E Foothill Blvd
First Floor
Upland, CA 91786-4079

Mailing address

1183 E Foothill Blvd
First Floor
Upland, CA 91786-4079
Phone (909) 367-7080

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation Hosp Phcy379 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1183 E Foothill Blvd
Fl First
Upland, CA 91786
Phone (909) 367-7080

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1114467883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1183 E FOOTHILL BLVD",
            "address_2": "FIRST FLOOR",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864079",
            "telephone_number": "909-367-7080",
            "fax_number": "909-367-7076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1183 E FOOTHILL BLVD",
            "address_2": "FIRST FLOOR",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864079",
            "telephone_number": "909-367-7080",
            "fax_number": "909-367-7076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANENTE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "EUGENIA",
        "authorized_official_title_or_position": "PHARMACY SUPERVISOR",
        "authorized_official_telephone_number": "909-367-7080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "36910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.