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

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Kaiser Foundation Health (67 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2134075OtherPK

Other names

  • Kaiser Permanente Townpark Infusion Pharmacy Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
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)

Other providers in Kennesaw, GA

All providers in Kennesaw, GA · Managed Care Organization Pharmacy in Georgia

Sources for this page

Verify at the official NPI Registry.