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KAISER PERMANENTE HENRY
NPI 1487697264
Pharmacy - Managed Care Organization Pharmacy in Mcdonough, GA

Active since June 13, 2006CLIA Certified · 2 labs
1125 TOWN CENTER VILLAGE DR, MCDONOUGH, GA 30253(678) 583-6560(678) 583-6563 Get Directions Write a Review

NPPES record last updated: August 4, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kaiser Permanente Henry NPPES

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

KAISER PERMANENTE HENRY (NPI 1487697264) is a healthcare organization registered as a managed care organization pharmacy in Mcdonough, Georgia and active in the NPI registry since June 2006. The organization holds 2 active CLIA laboratory certificates and lists Diane Sanders, Phcy Compliance Mgr, as its authorized official.

NPPES Registry Identity

NPI1487697264
Entity TypeOrganization
Primary Taxonomy3336M0003X
Legal Business NameKAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Location Address1125 TOWN CENTER VILLAGE DRMcdonough, GA 30253-5970
Mailing Address1125 Town Center Village DrMcdonough, GA 30253-5970 · (678) 583-6560 · Fax (678) 583-6563
Phone(678) 583-6560
Fax(678) 583-6563
Organization SubpartNo
Authorized OfficialDiane SandersPhcy Compliance Mgr · (770) 712-5654
Enumeration DateJune 13, 2006
Last NPPES UpdateAugust 4, 2021
NPPES CertifiedAugust 4, 2021
✔ NPI 1487697264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Managed Care Organization PharmacySuppliers
Taxonomy Code3336M0003X
License✔ Licensed in GA · PHRE008647
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.

Also ListedPharmacyTaxonomy 333600000X
1125 TOWN CENTER VILLAGE DR, Mcdonough, GA 30253
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Other Names 1

Doing Business AsKaiser Permanente Henry

Other Identifiers 1

Other1150250Ncpdp 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 2

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 for Provider-Performed Microscopy Procedures (PPMP) 11D2060501

Kaiser Permanente Henry Towne Centre · Mcdonough, GA
Active · expires Nov 19, 2027
CLIA Number11D2060501
Laboratory TypeHealth Main. Organization
Certificate Effective DateNovember 20, 2025
Certificate Expiration DateNovember 19, 2027
Laboratory DirectorTina Robinson
Laboratory Phone(678) 583-6555
Laboratory LocationKaiser Permanente Henry Towne Centre1125 Towne Center Village Drive, Mcdonough, GA 30253
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 11D1003937

Kaiser Permanente Henry Towne Laboratory · Mcdonough, GA
Active · expires Feb 3, 2027
CLIA Number11D1003937
Laboratory TypeAncillary Testing Site In Health Care Center
Certificate Effective DateFebruary 4, 2025
Certificate Expiration DateFebruary 3, 2027
Laboratory DirectorSylveria O. Olatidoye
Laboratory Phone(678) 583-6557
Laboratory LocationKaiser Permanente Henry Towne Laboratory1125 Henry Towne Center Village Drive, Mcdonough, GA 30253
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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.

DR. RACHEL DALETH GAINSBRUGH PHARM.D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1125 TOWN CENTER VILLAGE DR
MCDONOUGH, GA 30253
Henry County (678) 583-6589
KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC.
Clinical Medical Laboratory
1125 TOWN CENTER VILLAGE DR
MCDONOUGH, GA 30253
Henry County (678) 583-6557
TRINIDAD D OSSELYN MD
Family Medicine
1125 TOWN CENTER VILLAGE DR, KAISER PERMANENTE HENRY TOWNE CENTRE MEDICAL CENTER
MCDONOUGH, GA 30253
Henry County (678) 583-6600
PAULA NICOLE BLOOM PSYD
Psychologist
1125 TOWN CENTER VILLAGE DR, KAISER PERMANENTE HENRY TOWNE CENTRE MEDICAL CENTER
MCDONOUGH, GA 30253
Henry County (770) 496-3414
DR. HITESH PATEL M.D.
Family Medicine
1125 TOWN CENTER VILLAGE DR
MCDONOUGH, GA 30253
Henry County (800) 877-0409
KENDRA ASANTEWAA LEWIS PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
1125 TOWN CENTER VILLAGE DR
MCDONOUGH, GA 30253
Henry County (678) 583-6598
MISS MARTA L FLOOD C.R.N.P.
Nurse Practitioner (Adult Health)
1125 TOWN CENTER VILLAGE DR, KAISER PERMANENTE TOWNE CENTRE MEDICAL CENTER
MCDONOUGH, GA 30253
Henry County (678) 583-6579
JULIE MARIE LEMEN CNP
Nurse Practitioner (Pediatrics)
1125 TOWN CENTER VILLAGE DR, KAISER PERMANETE HENRY TOWNE CENTRE MEDICAL CENTER
MCDONOUGH, GA 30253
Henry County (678) 583-6600

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 1487697264. It was assigned to this organization in the NPPES registry on June 13, 2006. The provider is doing business as Kaiser Permanente Henry.

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

Kaiser Foundation Health Plan Of Georgia, Inc. is located at 1125 Town Center Village Dr, Mcdonough, GA 30253. The listed phone number is (678) 583-6560.

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 CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

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 with the weekly NPPES data releases published by CMS.