KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.


Address: 684 Sixes Rd Ste 275, Holly Springs, GA 30115-8721
Phone: 7708522440

KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC. (NPI# 1881910552) 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) 1881910552
Entity Type Organization
Organization Name KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Other Organization Name KAISER PERMANENTE HOLLY SPRINGS
Practice Address 684 Sixes Rd Ste 275
Holly Springs
GA 30115-8721
Practice Telephone 7708522440
Practice Fax Number 7708522441
Mailing Telephone 7708522440
Mailing Fax Number 7708522441
Enumeration Date 2010-04-20
Last Update Date 2010-06-22
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
PHRE009659 GA Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
NCPDP PROVIDER IDENTIFICATION NUMBER 1159715 01

Other Provider/Organization Names

Other Name Type Code
Kaiser Permanente Holly Springs 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
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
1366622912 Kaiser Foundation Health Plan of Georgia, Inc. Pharmacy 8011 Mall Pkwy, Lithonia, GA 30038-2543 2007-11-13

Office Location

Street Address 684 SIXES RD STE 275
City HOLLY SPRINGS
State GA
Zip Code 30115-8721

Providers in the same location

NPI Name Taxonomy Address Enumeration
1154684454 Jennifer Yam Family Medicine 684 Sixes Rd Ste 275, Holly Springs, GA 30115-8723 2012-06-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1497364806 Amanda Arbogast Speech-Language Pathologist 610 Royal Crest Court, Canton, GA 30115 2020-07-31
1033754163 Kelly Marie Shirley Nurse Practitioner 450 Northside Cherokee Blvd., Radiology Dept., Canton, GA 30115 2019-11-13
1700394319 Jennifer Lynn Davenport Nurse Practitioner 684 Sixes Rd Ste 125, Holly Springs, GA 30115 2018-01-17
1851717961 Wal-mart Stores East, Lp Technician/Technologist 2200 Holly Springs Pkey, Holly Springs, GA 30115 2014-03-13
1194148502 Julia Bedingfield Reid Pharmacist 450 Northside Cherokee Blvd Ste T20, Canton, GA 30115 2014-01-22
1447597992 America's Best Contacts & Eyeglasses Technician/Technologist 2030 Cumming Highway, Suite 106, Canton, GA 30115 2013-01-03
1679821193 Jill M Decorso Speech-Language Pathologist 4280 Hickory Flat Hwy, Ste 108, Canton, GA 30115 2012-08-15
1306113378 Sidney Boyd Collier IIi Pharmacist 6111 Hickory Flat Highway, Canton, GA 30115 2011-11-18
1174804702 Rayllensons Itacy Physician Assistant 2020 Cumming Highway, Suite 102, Canton, GA 30115 2011-09-09
1245534346 Kim M. Mcmillan Counselor 154 Lakeside Drive, Canton, GA 30115 2011-01-04
Find all providers in zip 30115

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
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
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
Find all providers with the same taxonomy

Competitor

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City HOLLY SPRINGS
Zip Code 30115

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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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