National Provider Identifier Database

SOUTHCENTRAL FOUNDATION
Multi-Specialty


Contact Information

SOUTHCENTRAL FOUNDATION
10 DNR ROAD
MCGRATH, AK99627
Phone: 907-524-3299
Fax:
Website:
Specialty Taxonomy Code
* Multi-Specialty 261QM1300X

* Indicates primary specialty

NPI Profile & details for SOUTHCENTRAL FOUNDATION

NPI Number 1063467223
Legal business name
LBN
SOUTHCENTRAL FOUNDATION
Authorized official RONALD OLSON - (EXECUTIVE VICE PRESIDENT FINANCE)
Entity Organization
Organization subpart Yes
Enumeration date 05/24/2006
Last updated 08/30/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • AK License #: 20467
  • AK Medicaid: 1000864

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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