Kaiser Foundation Health Plan of Georgia Inc
Organization Active NPI Managed Care Organization Pharmacy · Kennesaw, GA
NPI 1265707244 · NPPES record last updated Aug 4, 2021
Key facts
- NPI
- 1265707244
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Managed Care Organization Pharmacy 3336M0003X
- Legal business name
- KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC
- Practice address
- 750 Townpark LN NW
Kennesaw, GA 30144-5579 - Phone
- (770) 514-5487
- Fax
- (770) 514-5433
- NPI assigned
- Mar 9, 2012
- Organization subpart
- No
Authorized official
- Name
- Ms. Diane Sanders
- Title
- Pharmacy Compliance Manager
- Phone
- (770) 712-5654
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Kaiser Foundation Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | PHCL000018 | GA | |
| Compounding Pharmacy | 3336C0004X | |||
| Managed Care Organization Pharmacy | 3336M0003X | Yes |
Addresses
Primary practice location
750 Townpark LN NW
Kennesaw, GA 30144-5579
Mailing address
750 Townpark LN NW
Kennesaw, GA 30144-5579
Phone (770) 514-5487
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2134075 | Other | PK |
Other names
- Kaiser Permanente Townpark Infusion Pharmacy
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) | |
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
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All providers in Kennesaw, GA · Managed Care Organization Pharmacy in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.