Kaiser Permanente Interstate South Pharmacy

LBN: Kaiser Foundation Health Plan Of The Northwest
Kaiser Permanente Interstate South Pharmacy is an health care organization with primary practice located at 3500 N Interstate Ave , Portland OR 97227-1196. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Clinic Pharmacy is the primary health care specialty. Kaiser Foundation Health Plan Of The Northwest can be contacted via phone (503) 331-6186, or through Lyman, Alfred via phone (800) 813-2000.

Contact Information

Primary practice address
3500 N Interstate Ave Portland OR 97227-1196
Phone: (503) 331-6186
Fax: (503) 331-6187
Website:
Map and Directions
Authorized official contact:
Name: Lyman, Alfred PHARMD, BCPS
Phone: (800) 813-2000

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X PHNR.FO.60572833 Washington
Suppliers / Clinic Pharmacy 3336C0002X RP-0001643-CS Oregon
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1730108168
LBN Legal business name Kaiser Foundation Health Plan Of The Northwest
DBA Doing business as Kaiser Permanente Interstate South Pharmacy
Authorized official Lyman, Alfred PHARMD, BCPS
Entity Organization
Organization subpart 1 No
Enumeration date Jul 18th, 2006
Last updated Jun 1st, 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 1730108168 NPPES
Oregon MEDICAID 500622283
Oregon MEDICAID 6029821
Oregon Other 2078923

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