Kaiser Permanente Pharmacy #379

LBN: Kaiser Foundation Health Plan Inc
Kaiser Permanente Pharmacy #379 is an health care organization with primary practice located at 2521 Michelle Dr Fl 1 , Tustin CA 92780-7014. 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 (855) 238-5632, or through Polchak, Rhonda Lee via phone (562) 658-3510.

Contact Information

Primary practice address
2521 Michelle Dr Fl 1 Tustin CA 92780-7014
Phone: (855) 238-5632
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Polchak, Rhonda Lee
Phone: (562) 658-3510

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY51668 California

Profile Details

NPI number 1942630207
LBN Legal business name Kaiser Foundation Health Plan Inc
DBA Doing business as Kaiser Permanente Pharmacy #379
Authorized official Polchak, Rhonda Lee
Entity Organization
Organization subpart 1 No
Enumeration date Nov 22nd, 2013
Last updated Jun 23rd, 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 1942630207 NPPES
California MEDICAID 1942630207
California Other 2143196
California Other 5649605

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