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KAISER PERMANENTE GLENLAKE
NPI 1093757809
Pharmacy - Managed Care Organization Pharmacy in Atlanta, GA

Active since June 13, 2006CLIA 11D0259776 · Certificate of Compliance
20 GLENLAKE PKWY NE, ATLANTA, GA 30328(770) 677-6000(770) 677-7306 Get Directions Write a Review

NPPES record last updated: August 4, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kaiser Permanente Glenlake NPPES

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

KAISER PERMANENTE GLENLAKE (NPI 1093757809) is a healthcare organization registered as a managed care organization pharmacy in Atlanta, Georgia and active in the NPI registry since June 2006. The organization holds a CLIA Certificate of Compliance certificate valid through November 17, 2026 and lists Diane Sanders, Phcy Compliance Mgr, as its authorized official.

NPPES Registry Identity

NPI1093757809
Entity TypeOrganization
Primary Taxonomy3336M0003X
Legal Business NameKAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Location Address20 GLENLAKE PKWY NEAtlanta, GA 30328-3473
Mailing Address20 Glenlake Pkwy NeAtlanta, GA 30328-3473 · (770) 677-6000 · Fax (770) 677-7306
Phone(770) 677-6000
Fax(770) 677-7306
Organization SubpartNo
Authorized OfficialDiane SandersPhcy Compliance Mgr · (770) 712-5654
Enumeration DateJune 13, 2006
Last NPPES UpdateAugust 4, 2021
NPPES CertifiedAugust 4, 2021
✔ NPI 1093757809 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Managed Care Organization PharmacySuppliers
Taxonomy Code3336M0003X
License✔ Licensed in GA · PHRE007915
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.
20 GLENLAKE PKWY NE, Atlanta, GA 30328
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Other Names 1

Doing Business AsKaiser Permanente Glenlake

Other Identifiers 1

Other1136971Ncpdp 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 ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 11D0259776

Kaiser Permanente Glenlake · Atlanta, GA
Active · expires Nov 17, 2026
CLIA Number11D0259776
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateNovember 18, 2024
Certificate Expiration DateNovember 17, 2026
Laboratory DirectorJames L. Lucarini
Laboratory Phone(770) 677-5830
Laboratory LocationKaiser Permanente Glenlake20 Glenlake Pkwy, Atlanta, GA 30328
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 9

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

SHAHIDUR RAHMAN MD
Pediatrics
20 GLENLAKE PKWY NE, GLENLAKE MEDICAL CENTER
ATLANTA, GA 30328
Fulton County (770) 677-6085
BRIAN JAEHOON CHUNG M.D.
Otolaryngology
20 GLENLAKE PKWY NE
ATLANTA, GA 30328
Fulton County (770) 677-6137
MR. JOHN DOUGLAS EDWARDS JR. R.P.A., RT(R)
Radiologic Technologist
20 GLENLAKE PKWY NE
ATLANTA, GA 30328
Fulton County (770) 677-5857
MR. ANUJ ASHWIN PATEL PHARM.D.
Pharmacist
20 GLENLAKE PKWY NE
ATLANTA, GA 30328
Fulton County (770) 677-6000
DR. SHERRY-ANN RENEE MARSHALL PHARM.D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
20 GLENLAKE PKWY NE
ATLANTA, GA 30328
Fulton County (770) 677-5869
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC.
Clinical Medical Laboratory
20 GLENLAKE PKWY NE
ATLANTA, GA 30328
Fulton County (770) 677-5830
LEWIS H HAMNER III MD
Obstetrics & Gynecology (Maternal & Fetal Medicine)
20 GLENLAKE PKWY NE, MATERNAL - FETAL MEDICINE / OBGYN
ATLANTA, GA 30328
Fulton County (770) 677-6116
DR. VANESSA ETHERIDGE SMITH PHARM.D.
Pharmacist (Pharmacotherapy)
20 GLENLAKE PKWY NE
ATLANTA, GA 30328
Fulton County (770) 677-5869

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kaiser Foundation Health Plan Of Georgia, Inc.'s NPI number?

The NPI number for Kaiser Foundation Health Plan Of Georgia, Inc. is 1093757809. It was assigned to this organization in the NPPES registry on June 13, 2006. The provider is doing business as Kaiser Permanente Glenlake.

Where is Kaiser Foundation Health Plan Of Georgia, Inc. located?

Kaiser Foundation Health Plan Of Georgia, Inc. is located at 20 Glenlake Pkwy NE, Atlanta, GA 30328. The listed phone number is (770) 677-6000.

What is Kaiser Foundation Health Plan Of Georgia, Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Managed Care Organization Pharmacy, with taxonomy code 3336M0003X.

Does Kaiser Foundation Health Plan Of Georgia, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 11D0259776) is associated with this NPI, valid through November 17, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kaiser Foundation Health Plan Of Georgia, Inc. accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 24 other insurers list Kaiser Foundation Health Plan Of Georgia, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kaiser Foundation Health Plan Of Georgia, Inc. was last updated on August 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.