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Contact Information

SOUTHCENTRAL FOUNDATION
2516 MOUNTAIN CIRCLE
PEDRO BAY, AK99647
 Phone: 907-850-2229
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for SOUTHCENTRAL FOUNDATION · (Female)

NPI Number 1144777046
Status Active
Credentials
Entity Individual
Enumeration date 09/08/2016
Last updated 09/01/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers
  • AK License # 20467
  • AK Medicaid 1654571
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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