Kaiser Permanente Pharmacy #122

LBN: Kaiser Foundation Health Plan Inc
Kaiser Permanente Pharmacy #122 is an health care organization with primary practice located at 25821 Vermont Ave Fl 1, Harbor City CA 90710-3518. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Kaiser Foundation Health Plan Inc can be contacted via phone (844) 424-1866, or through Polchak, Rhonda Lee via phone (562) 658-3510.

Contact Information

Primary practice address
25821 Vermont Ave Fl 1 Harbor City CA 90710-3518
Fax:
Website:
Authorized official contact:
Name: Polchak, Rhonda Lee

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY51848 California

Profile Details

NPI number 1104244490
LBN Legal business name Kaiser Foundation Health Plan Inc
DBA Doing business as Kaiser Permanente Pharmacy #122
Authorized official Polchak, Rhonda Lee
Entity Organization
Organization subpart 1 No
Enumeration date Apr 3rd, 2014
Last updated Jul 5th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104244490 NPPES
California MEDICAID 1104244490
California Other 2145571
California Other 5651268

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