KAISER PERMANENTE WEST MARIETTA
NPI 1063733210
Pharmacy - Managed Care Organization Pharmacy in Marietta, GA
NPI Status: Active since June 22, 2010
Contact Information
2505 DALLAS HWY SW
MARIETTA, GA
ZIP 30064
Phone: (770) 792-2010
Fax: (770) 792-2003
- Organization
- Pharmacy
- Managed Care Organization Pharmacy
- CLIA Number: 11D2150459
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 06-25-2026
About KAISER PERMANENTE WEST MARIETTA
This page provides the complete NPI Profile along with additional information for Kaiser Permanente West Marietta, a provider established in Marietta, Georgia operating as a Pharmacy, focusing in managed care organization pharmacy . The healthcare provider is registered in the NPI registry with number 1063733210 assigned on June 2010. The practitioner's primary taxonomy code is 3336M0003X with license number PHRE009685 (GA). The provider is registered as an organization and their NPI record was last updated 11 years ago. The provider's is doing business as Kaiser Permanente West Marietta. The authorized official of this NPI record is Diane Sanders (Pharmacy Compliance Manager)
- NPI
- 1063733210
- Provider Legal Name
- KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
- Other Organization Name
- KAISER PERMANENTE WEST MARIETTA
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2505 DALLAS HWY SW MARIETTA, GA 30064
- Location Phone
- (770) 792-2010
- Location Fax
- (770) 792-2003
- Mailing Address
- 3495 PIEDMONT RD NE ATLANTA, GA 30305
- Mailing Phone
- (404) 364-4824
- Mailing Fax
- (770) 792-2003
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-22-2010
- Last Update Date
- 07-10-2015
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Managed Care Organization Pharmacy
- Taxonomy Code
- 3336M0003X
- Type
- Suppliers
- License No.
- PHRE009685
- License State
- GA
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 333600000X | Suppliers | Pharmacy |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2125368 | OTHER (01) | PK |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 11D2150459
- Facility Type
- Physician Office
- Certificate Effective Date
- June 26, 2024
- Certificate Expiration Date
- June 25, 2026
- Laboratory Director
- MADELEINE FORTIN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Kaiser Permanente West Marietta to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1063733210, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 50 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063733210, enumerated as an "organization" on June 22, 2010.
The provider is located at 2505 DALLAS HWY SW MARIETTA, GA 30064 and the phone number is (770) 792-2010.
Pharmacy with taxonomy code 3336M0003X and a focus in Managed Care Organization Pharmacy.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
