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Kaiser Foundation Health Plan Of Georgia, Inc.
Managed Care Organization Pharmacy in Conyers, Georgia
NPI 1174826754

Kaiser Foundation Health Plan Of Georgia, Inc. is a Managed Care Organization Pharmacy based in Conyers, GA and is specialized in Managed Care Organization Pharmacy. Kaiser Foundation Health Plan Of Georgia, Inc. practices in Conyers, GA. The NPI Number for Kaiser Foundation Health Plan Of Georgia, Inc. is 1174826754 and holds a License No. PHRE009716 (Georgia).

The current practice location address for Kaiser Foundation Health Plan Of Georgia, Inc. is 1478 Dogwood Dr Se, Conyers, GA and can be reached out via phone at 678-413-4321 and via fax at 678-413-4323.

Location: 1478 Dogwood Dr Se, Conyers, GA, 30013-5088
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1174826754
Provider Name
Kaiser Foundation Health Plan Of Georgia, Inc.
Credential
Provider Entity Type
Organization
Address
1478 Dogwood Dr Se, Conyers, GA, 30013-5088
Phone Number
678-413-4321
Fax Number
678-413-4323
Provider Enumeration Date
12/21/2010
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1160756 01 NCPDP PROVIDER IDENTIFICATION NUMBER
institution
Provider Business Practice Location Address Details
Address
1478 Dogwood Dr Se
City
Conyers
State
Georgia
Zip
30013-5088
Phone Number
678-413-4321
Fax Number
678-413-4323
person
Provider Business Mailing Address Details
Address
1478 Dogwood Dr Se
City
Conyers
State
Georgia
Zip
30013-5088
Phone Number
678-413-4321
Fax Number
678-413-4323
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Pharmacy
Speciality
-
Taxonomy
333600000X
License No.
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Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Pharmacy
Speciality
Managed Care Organization Pharmacy
Taxonomy
3336M0003X
License No.
PHRE009716 (Georgia)
Definition
A pharmacy owned by a managed care organization (MCO) used by pharmacists for the compounding and dispensing of medicinal preparations to that MCO's covered members only.
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