| NPI | 1093757809 |
|---|---|
| Doing Business As | KAISER PERMANENTE GLENLAKE |
| Entity Type | Organization |
| Authorized Contact | DIANE SANDERS Phcy Compliance Mgr 770-712-5654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336M0003X Pharmacy, Managed Care Organization Pharmacy (Licence: GA PHRE007915) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2021-08-04 |