Kaiser Permanente Conyers

LBN: Kaiser Foundation Health Plan Of Georgia, Inc.
Kaiser Permanente Conyers is an health care organization with primary practice located at 1478 Dogwood Dr Se , Conyers GA 30013-5088. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Managed Care Organization Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Kaiser Foundation Health Plan Of Georgia, Inc. can be contacted via phone (678) 413-4321, or through Sanders, Diane via phone (770) 712-5654.

Contact Information

Primary practice address
1478 Dogwood Dr Se Conyers GA 30013-5088
Fax: (678) 413-4323
Website:
Authorized official contact:
Name: Sanders, Diane

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X PHRE009716 Georgia
Suppliers / Managed Care Organization Pharmacy 3336M0003X

Profile Details

NPI number 1174826754
LBN Legal business name Kaiser Foundation Health Plan Of Georgia, Inc.
DBA Doing business as Kaiser Permanente Conyers
Authorized official Sanders, Diane
Entity Organization
Organization subpart 1 No
Enumeration date Dec 21st, 2010
Last updated Aug 4th, 2021 - about 4 years ago

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 1174826754 NPPES
Other 1160756 NCPDP PROVIDER IDENTIFICATION NUMBER

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