KAISER PERMANENTE PHARMACY NO 179 - NPI 1063569390 - Pharmacy in Rancho Cucamonga, CA

Q: What is Kaiser Foundation Health Plan Inc's NPI number?

The NPI number for Kaiser Foundation Health Plan Inc is 1063569390. It was assigned to this organization in the NPPES registry on January 5, 2007. The provider is also known as Kaiser Permanente Pharmacy No 179.

Q: What is Kaiser Foundation Health Plan Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

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About Kaiser Permanente Pharmacy No 179 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KAISER PERMANENTE PHARMACY NO 179 (NPI 1063569390) is a healthcare organization registered as a community/retail pharmacy in Rancho Cucamonga, California and active in the NPI registry since January 2007. The organization lists Rhonda Lee Polchak, Vp Pharmacy Operations & Svcs, Scal, as its authorized official.

NPPES Registry Identity

NPI1063569390

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameKAISER FOUNDATION HEALTH PLAN INC

Location Address10850 ARROW RTERancho Cucamonga, CA 91730-4833

Mailing Address12254 Bellflower Blvd Fl 2, Pharmacy OperationsDowney, CA 90242-2804

Phone(866) 342-2822

Organization SubpartNo

Authorized OfficialRhonda Lee PolchakVp Pharmacy Operations & Svcs, Scal · (562) 658-3510

Enumeration DateJanuary 5, 2007

Last NPPES UpdateJune 13, 20232 updates tracked since enumeration

NPPES CertifiedJune 13, 2023

✔ NPI 1063569390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in CA · PHY43772

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedPharmacyTaxonomy 333600000X

10850 ARROW RTE, Rancho Cucamonga, CA 91730

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Other Names 1

Other NameKaiser Permanente Pharmacy No 179

Other Identifiers 2

Medicaid1063569390CA

Other5617355Ncpdp Provider Identification Number

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. SAMUEL LISAMA VILLAPANDO

Student in an Organized Health Care Education/Training Program