NPI age
18 years
Enumerated 2007-11-13
● Active Type 2 · Organization
Kaiser Foundation Health Plan Of Georgia, Inc.
Kaiser Foundation Health Plan Of Georgia, Inc. is 1 of 37 pharmacy organizations in Georgia.
Primary specialty
Pharmacy
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Sanders
Pharmacy Compliance Manager
Last NPPES update
2021-08-04
Source: monthly bulk 2026-05
How this organization compares
Across 37 active pharmacy providers in Georgia.
NPI age
18 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-11Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
8011 Mall Pkwy
Lithonia, GA 300382543
Mailing address
8011 Mall Pkwy
Lithonia, GA 300382543
Authorized official
Diane Sanders
Pharmacy Compliance Manager
📞 7707125654
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Shantae Mangaroo, M.D. Family Medicine NPI 1902293434
- Miesha Rhodes, LCSW Social Worker NPI 1770098766
Specialties
-
Pharmacy PrimaryA 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.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 1156531 | NCPDP PROVIDER IDENTIFICATION NUMBER |
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
KAISER PERMANENTE STONECREST
-
KAISER PERMANENTE STONECREST
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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