Kaiser Permanente Pharmacy #508
LBN: Kaiser Foundation Health Plan Inc
Kaiser Permanente Pharmacy #508 is an health care organization with primary practice located at 12815 Heacock St , Moreno Valley CA 92553-3116. 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 (866) 370-1908, or through Polchak, Rhonda Lee via phone (562) 658-3510.
Contact Information
Primary practice address
12815 Heacock St
Moreno Valley CA 92553-3116
Phone: (866) 370-1908
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | PHY37646 | California |
Profile Details
| NPI number | 1467500066 |
|---|---|
| LBN Legal business name | Kaiser Foundation Health Plan Inc |
| DBA Doing business as | Kaiser Permanente Pharmacy #508 |
| Authorized official | Polchak, Rhonda Lee |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 8th, 2007 |
| Last updated | Jun 21st, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467500066 | NPPES |
| California | MEDICAID | 1467500066 | |
| California | Other | 0503309 |
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