Kaiser Foundation Health Plan of Georgia, Inc.
Organization Active NPI Managed Care Organization Pharmacy · Atlanta, GA
NPI 1295840189 · NPPES record last updated Aug 4, 2021
Key facts
- NPI
- 1295840189
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Managed Care Organization Pharmacy 3336M0003X
- License
- PHRE007009 (GA)
- Legal business name
- KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
- Practice address
- 2525 Cumberland Pkwy SE
Atlanta, GA 30339-3915 - Phone
- (770) 431-4136
- Fax
- (770) 431-4194
- NPI assigned
- Aug 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Diane Sanders
- Title
- Phcy Compliance MGR
- Phone
- (770) 712-5654
Corporate family (same tax ID) 24
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D0260210 | Kaiser Permanente Cumberland Laboratory | Registration | Oct 9, 2026 |
National Provider Directory
- Tax ID family
- Kaiser Foundation Health
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Managed Care Organization Pharmacy | 3336M0003X | PHRE007009 | GA | Yes |
Addresses
Primary practice location
2525 Cumberland Pkwy SE
Atlanta, GA 30339-3915
Mailing address
2525 Cumberland Pkwy SE
Atlanta, GA 30339-3915
Phone (770) 431-4136
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1140944 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names
- KAISER PERMANENTE CUMBERLAND
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggateways | Health Information Exchange (HIE) |
Other providers in Atlanta, GA
- Kaiser Foundation Health Plan of Georgia Inc.
- Kaiser Foundation Health Plan of Georgia Inc.
- Kaiser Foundation Health Plan of Georgia Inc.
- Kaiser Foundation Health Plan of Georgia Inc.
- Kaiser Foundation Health Plan of Georgia, Inc.
- Kaiser Foundation Health Plan of Georgia, Inc.
- Kaiser Foundation Health Plan of Georgia, Inc.
- Kaiser Foundation Health Plan of Georgia, Inc.
- Kaiser Foundation Health Plan of Georgia, Inc.
- Kaiser Foundation Health Plan of Georgia, Inc.
All providers in Atlanta, 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.