Kaiser Permanente Southwood Clinic Pharmacy

LBN: Kaiser Foundation Health Plan Of Georgia, Inc.
Kaiser Permanente Southwood Clinic Pharmacy is an health care organization with primary practice located at 2400 Mount Zion Pkwy , Jonesboro GA 30236-2500. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Managed Care Organization Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty. Kaiser Foundation Health Plan Of Georgia, Inc. can be contacted via phone (770) 603-4242, or through Sanders, Diane via phone (770) 712-5654.

Contact Information

Primary practice address
2400 Mount Zion Pkwy Jonesboro GA 30236-2500
Phone: (770) 603-4242
Fax: (770) 603-4243
Website:
Map and Directions
Authorized official contact:
Name: Sanders, Diane
Phone: (770) 712-5654

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Clinic Pharmacy 3336C0002X PHCL000025 Georgia
Suppliers / Managed Care Organization Pharmacy 3336M0003X

Profile Details

NPI number 1861817017
LBN Legal business name Kaiser Foundation Health Plan Of Georgia, Inc.
DBA Doing business as Kaiser Permanente Southwood Clinic Pharmacy
Authorized official Sanders, Diane
Entity Organization
Organization subpart 1 No
Enumeration date Feb 25th, 2014
Last updated Aug 4th, 2021 - about 3 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 1861817017 NPPES
Other 2144375 PK

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