KAISER PERMANENTE DOUGLASVILLE – NPI #1316251598
Pharmacy

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.

KAISER PERMANENTE DOUGLASVILLE is a pharmacy located in DOUGLASVILLE, GA. NPPES has assigned the NPI number 1316251598 to KAISER PERMANENTE DOUGLASVILLE on July 30, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “KAISER PERMANENTE DOUGLASVILLE” is a dba name, the actual legal business name for this organization is KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 3336M0003X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy, specializing in Managed Care Organization Pharmacy

The NPI profile was previously updated about 5 years ago on Aug 04, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KAISER PERMANENTE DOUGLASVILLE below.

NPI Profile for
KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.

NPI Number
1316251598
Enumeration Date

(about 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Doing Business As (dba): KAISER PERMANENTE DOUGLASVILLE
Primary location
6875 DOUGLAS BLVD
DOUGLASVILLE, GA 30135-7133
Phone: (678) 838-2226 Fax: (678) 838-2231
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DIANE SANDERS
PHARMACY COMPLIANCE MANAGER
Phone: (770) 712-5654
Updated
Certification Date
Aug 04, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for KAISER PERMANENTE DOUGLASVILLE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERPK2125971
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
3336M0003X
- Pharmacy / Managed Care Organization Pharmacy (Primary)
GA PHRE009688
3336C0003X
- Pharmacy / Community/Retail Pharmacy
333600000X
- Pharmacy

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggateways
Endpoint type
SOAP URL
Endpoint Description
CAREQUALITY
Content Type
OTHER
Affiliation
N
Endpoint Location
6875 DOUGLAS BLVD,
DOUGLASVILLE, GA 77025-1669