KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. (NPI# 1487769378) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487769378 |
Entity Type | Organization |
Organization Name | KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. |
Other Organization Name | KAISER PERMANENTE PANOLA |
Practice Address |
5440 Hillandale Dr Lithonia GA 30058-4865 |
Practice Telephone | 7703222737 |
Practice Fax Number | 7703223283 |
Mailing Telephone | 7703222737 |
Mailing Fax Number | 7703223283 |
Enumeration Date | 2006-08-20 |
Last Update Date | 2009-11-09 |
Authorized Official Name | DIANE SANDERS (PHCY COMPLIANCE MGR) |
Authorized Official Telephone | 4049495336 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
PHRE007143 | GA | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NCPDP PROVIDER IDENTIFICATION NUMBER | 1136743 | 01 |
Other Name | Type Code |
---|---|
KAISER PERMANENTE PANOLA | Doing Business As Name - Organization |
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 |
1144546920 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 455 Philip Blvd Ste 130, Lawrenceville, GA 30046-8767 | 2010-04-19 |
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 |
Street Address |
5440 HILLANDALE DR |
City | LITHONIA |
State | GA |
Zip Code | 30058-4865 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417985193 | Faye M Riley | Internal Medicine | 5440 Hillandale Dr, Panola Medical Center, Lithonia, GA 30058-4865 | 2006-06-29 |
1821610924 | Allison Wimbush | Pharmacist | 5440 Hillandale Dr, Lithonia, GA 30058-4865 | 2020-05-12 |
1114556362 | Amy Marie Schlabach | Pharmacist | 5440 Hillandale Dr, Lithonia, GA 30058-4865 | 2020-04-08 |
1265940670 | Rumbidzai Cunningham | Nurse Practitioner | 5440 Hillandale Dr, Lithonia, GA 30058-4865 | 2018-01-19 |
1134502198 | Ricia Taylor | Dietitian, Registered | 5440 Hillandale Dr, Lithonia, GA 30058-4865 | 2015-07-08 |
1245589639 | Elizabeth Marie Sutton | Pharmacist | 5440 Hillandale Dr, Lithonia, GA 30058-4865 | 2012-08-31 |
1598044158 | Bresha Shaw Franklin | Pharmacist | 5440 Hillandale Dr, Lithonia, GA 30058-4865 | 2011-08-12 |
1588827117 | Kaiser Foundation Health Plan of Georgia Inc. | Clinical Medical Laboratory | 5440 Hillandale Dr, Lithonia, GA 30058-4865 | 2008-07-03 |
1043367840 | Kimberly Carter | Internal Medicine | 5440 Hillandale Dr, Lithonia, GA 30058-4865 | 2007-01-04 |
1205999877 | Sharon Jackson White | Nurse Practitioner | 5440 Hillandale Dr, Lithonia, GA 30058-4865 | 2006-12-18 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821603606 | Sherenda Lashawn Ellis | Contractor | 1859 Petite Lane, Lithonia, GA 30058 | 2020-09-09 |
1477186807 | Reset Recovery Health Center LLC | Substance Abuse Rehabilitation Facility | 6978 Main St, Lithonia, GA 30058 | 2020-02-13 |
1346726122 | Myorganics | Spec/Tech, Pathology | 5910 Shadow Rock Dr, Lithonia, GA 30058 | 2018-07-16 |
1699251884 | Enriching Medical Transport | Ambulance | 2260 Lithonia Industrial Blvd., Ste N-b, Lithonia, GA 30058 | 2018-07-11 |
1841789914 | Milner Vein and Vascular LLC | Surgery | 5700 Hillandale Dr Ste 150, Lithonia, GA 30058 | 2018-05-04 |
1215451265 | Brittany Rawlings | Home Health | 6127 Howell Ridge, Lithonia, GA 30058 | 2017-08-01 |
1982125571 | Bella Intellectum, LLC | Technician/Technologist | 6803 Edmonton Ct., Lithonia, GA 30058 | 2017-07-05 |
1528589397 | Arlene Dennis | Registered Nurse | 6022 Arnor Links Road, Lithonia, GA 30058 | 2017-07-03 |
1417401746 | Two Caring Hands Private Home Care | Home Health | 1959 Singers Way, Lithonia, GA 30058 | 2016-08-03 |
1518347467 | Ortho Injury and Wellness Center Inc. | Clinic/Center | 6148 A Covington Hwy, Lithonia, GA 30058 | 2015-06-05 |
Find all providers in zip 30058 |
Taxonomy Code | 3336M0003X |
Grouping | Suppliers |
Classification | Pharmacy |
Specialization | Managed Care Organization 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. |
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] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366622912 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 8011 Mall Pkwy, Lithonia, GA 30038-2543 | 2007-11-13 |
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 |
1144546920 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 455 Philip Blvd Ste 130, Lawrenceville, GA 30046-8767 | 2010-04-19 |
1699003681 | Kaiser Foundation Health Plan of Georgia, Inc. | Pharmacy | 201 W Ponce De Leon Ave, Decatur, GA 30030-3217 | 2009-12-02 |
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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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.