Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kaiser Foundation Health Plan of Georgia, Inc

Organization Managed Care Organization Pharmacy · NPI 1093757809

Kaiser Foundation Health Plan of Georgia, Inc is a Managed Care Organization Pharmacy in Atlanta, Georgia. Licensed in Georgia. Registered with an NPI since 2006.

Licensed in
GA
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

20 Glenlake Pkwy NE
Atlanta, GA 30328-3473
Phone: (770) 677-6000
Fax: (770) 677-7306
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Managed Care Organization Pharmacy (primary) Taxonomy 3336M0003X · Licence PHRE007915 (GA)

Record details

NPI number1093757809
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Diane Sanders — Phcy Compliance Mgr · (770) 712-5654
Other names Kaiser Permanente Glenlake; Kaiser Permanente Glenlake
NPI enumeratedJune 13, 2006
Last updated in NPPESAugust 4, 2021
Certification dateAugust 4, 2021
Mailing address20 Glenlake Pkwy Ne, Atlanta, GA 30328-3473

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