Kaiser Permanente Pharmacy No 157

LBN: Kaiser Foundation Health Plan Inc
Kaiser Permanente Pharmacy No 157 is an health care organization with primary practice located at 14011 Park Ave , Victorville CA 92392-2413. 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) 352-1151, or through Polchak, Rhonda Lee via phone (562) 658-3510.

Contact Information

Primary practice address
14011 Park Ave Victorville CA 92392-2413
Fax:
Website:
Authorized official contact:
Name: Polchak, Rhonda Lee

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY43724 California

Profile Details

NPI number 1548317860
LBN Legal business name Kaiser Foundation Health Plan Inc
DBA Doing business as Kaiser Permanente Pharmacy No 157
Authorized official Polchak, Rhonda Lee
Entity Organization
Organization subpart 1 Yes
Enumeration date Jan 5th, 2007
Last updated Jun 13th, 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 1548317860 NPPES
California MEDICAID 1548317860
California Other 0501812

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