KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.


Address: 455 Philip Blvd Ste 130, Lawrenceville, GA 30046-8767
Phone: 6789855040

KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. (NPI# 1144546920) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144546920
Entity Type Organization
Organization Name KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Other Organization Name KAISER PERMANENTE LAWRENCEVILLE
Practice Address 455 Philip Blvd Ste 130
Lawrenceville
GA 30046-8767
Practice Telephone 6789855040
Practice Fax Number 6789855003
Mailing Telephone 6789855040
Mailing Fax Number 6789855003
Enumeration Date 2010-04-19
Last Update Date 2010-06-01
Authorized Official Name DIANE SANDERS (PHARMACY COMPLIANCE MANAGER)
Authorized Official Telephone 4049495336
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3336M0003X Pharmacy
Specialization: Managed Care Organization Pharmacy
PHRE009655 GA Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
NCPDP PROVIDER IDENTIFICATION NUMBER 1159703 01

Other Provider/Organization Names

Other Name Type Code
Kaiser Permanente Lawrenceville Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1811321763 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 1100 Lake Hearn Dr Ste 500, Atlanta, GA 30342-1548 2013-08-28
1598061608 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 225 Peachtree St Ne Ste C-08, Atlanta, GA 30303-1701 2011-02-07
1174826754 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 1478 Dogwood Dr Se, Conyers, GA 30013-5088 2010-12-21
1053612119 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 205 Newnan Crossing Byp, Newnan, GA 30265-1063 2010-11-05
1063733210 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 2505 Dallas Hwy Sw, Marietta, GA 30064-2659 2010-06-22
1538480553 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 2240 Fountain Dr, Snellville, GA 30078-2919 2010-06-14
1881910552 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 684 Sixes Rd Ste 275, Holly Springs, GA 30115-8721 2010-04-20
1699003681 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 201 W Ponce De Leon Ave, Decatur, GA 30030-3217 2009-12-02
1447487574 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 1400 Northside Forsyth Dr Ste 350, Cumming, GA 30041-6018 2009-06-16
1366622912 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 8011 Mall Pkwy, Lithonia, GA 30038-2543 2007-11-13

Office Location

Street Address 455 PHILIP BLVD STE 130
City LAWRENCEVILLE
State GA
Zip Code 30046-8767

Providers in the same location

NPI Name Taxonomy Address Enumeration
1154702157 Marc Ghabbour Internal Medicine 455 Philip Blvd Ste 130, Lawrenceville, GA 30046 2015-06-16

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1063023174 Alpha & Omega Hearing Centers Hearing Instrument Specialist Alpha & Omega Hearing Centers, 250 Langley Drive, Suite 1106, Lawrenceville, GA 30046 2020-08-12
1285259846 Mesun Health Services, Inc Clinical Nurse Specialist 88 Johnson Rd Building # 1-b, Lawrenceville, GA 30046 2020-06-10
1215550264 Mesun Health Services, Inc Skilled Nursing Facility 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 2020-05-26
1306499785 Bryan Acosta Chiropractor 471 Scenic Hwy South, Lawrenceville, GA 30046 2019-07-24
1205308616 Belle Lumiere Cosmetics LLC Dermatology 753 Old Norcross Road, Lawrenceville, GA 30046 2018-12-24
1548730179 Alexis Nicole Robinson Nurse Anesthetist, Certified Registered 1000 Medical Center Boulevard, Lawrenceville, GA 30046 2018-11-27
1679060388 Christopher Puckett Student in an Organized Health Care Education/Training Program 665 Duluth Hwy Suite 501, Lawrenceville, GA 30046 2018-04-18
1457851255 Advanced Urology Institute of Georgia Urology 501 Crown Point Way, Lawrenceville, GA 30046 2018-02-19
1013447044 Pharmacy Investments of Lawrenceville, LLC Pharmacy 738 Old Norcross Road, Ste A, Lawrenceville, GA 30046 2017-06-13
1225577000 Priority Housecalls LLC Clinic/Center 225 Scenic Hwy, Ste 200, Lawrenceville, GA 30046 2017-02-14
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Taxonomy Information

Taxonomy Code 3336M0003X
Grouping Suppliers
Classification Pharmacy
Specialization Managed Care Organization Pharmacy

Taxonomy 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.
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1316465859 Integrated Health Solutions LLC Pharmacy 1284 Glandor Ct Se, Mableton, GA 30126-2755 2017-09-05
1174826754 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 1478 Dogwood Dr Se, Conyers, GA 30013-5088 2010-12-21
1053612119 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 205 Newnan Crossing Byp, Newnan, GA 30265-1063 2010-11-05
1881910552 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 684 Sixes Rd Ste 275, Holly Springs, GA 30115-8721 2010-04-20
1699003681 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 201 W Ponce De Leon Ave, Decatur, GA 30030-3217 2009-12-02
1366622912 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 8011 Mall Pkwy, Lithonia, GA 30038-2543 2007-11-13
1518090836 Northeast Georgia Health Services Pharmacy 825 Jesse Jewell Parkway Suite D, Gainesville, GA 30501-3715 2007-03-14
1578606950 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 3640 Tramore Pointe Pkwy, Austell, GA 30106-6825 2007-02-15
1568577450 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 1745 Peachtree Rd Ne, Atlanta, GA 30309-2410 2006-08-20
1932141710 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 2006-06-13
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Competitor

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City LAWRENCEVILLE
Zip Code 30046

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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