SOUTHCENTRAL FOUNDATION; NPI #1144699216

Contact Information

SOUTHCENTRAL FOUNDATION

4030 SALMON WAY
IGIUGIG, AK 99613

Phone: 907-533-3207
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Community Health	261QC1500X

Indicates primary specialty

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NPI Profile & details for SOUTHCENTRAL FOUNDATION

NPI Number 1144699216

LBN Legal business name SOUTHCENTRAL FOUNDATION

Authorized official RONALD OLSON - (EXECUTIVE VICE PRESIDENT FINANCE)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 09/18/2015

Last updated 08/31/2023 - About 3 years ago

Identifiers

AK	License #	20467
AK	Medicaid	1637735

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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