NPIMap

Organization Active NPI

Kaiser Foundation Health Plan Inc

Doing business as Kaiser Permanente Pharmacy No 672

  • Community/Retail Pharmacy
  • Vacaville, CA
National Provider Identifier
1467500298
Registry record updated May 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PHY46045 Issued in CA
Legal business name
KAISER FOUNDATION HEALTH PLAN INC
Doing business as
Kaiser Permanente Pharmacy No 672
Practice address
3700 Vaca Valley Pkwy FL 2
Vacaville, CA 95688-9430
Phone
(707) 453-5202
Fax
(707) 453-2959
NPI assigned
Jan 8, 2007
Last updated
May 20, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2010

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

Authorized official

Name
Albert Carver
Title
VP Phrmcy Strategy Operations
Phone
(562) 658-3510

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X PHY46045 CA Primary
Managed Care Organization Pharmacy 3336M0003X NU

Addresses

Primary practice location

3700 Vaca Valley Pkwy FL 2
Vacaville, CA 95688-9430

Mailing address

3700 Vaca Valley Pkwy FL 2
Vacaville, CA 95688-9430

Other identifiers 2

IdentifierTypeStateIssuer
PHA460450MedicaidCA
0585729OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • KAISER PERMANENTE PHARMACY NO 672 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation HLTH379 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

1 Quality Dr
Fl 2
Vacaville, CA 95688
Phone (707) 453-5202

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274313600000",
    "number": "1467500298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 VACA VALLEY PKWY FL 2",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956889430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 VACA VALLEY PKWY FL 2",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956889430",
            "telephone_number": "707-453-5202",
            "fax_number": "707-453-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2010-05-20",
        "status": "A",
        "authorized_official_last_name": "CARVER",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "VP PHRMCY STRATEGY OPERATIONS",
        "authorized_official_telephone_number": "562-658-3510"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY46045",
            "primary": true
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA460450",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0585729",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KAISER PERMANENTE PHARMACY NO 672",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; 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.