SOUTHCENTRAL FOUNDATION; NPI #1255881637

Contact Information

SOUTHCENTRAL FOUNDATION

4330 ELMORE RD
ANCHORAGE, AK 99508-5907

Phone: 907-729-6690
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Multi-Specialty	261QM1300X	70	Clinic or Group Practice
Community/Behavioral Health	251S00000X

Indicates primary specialty

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NPI Profile & details for SOUTHCENTRAL FOUNDATION

NPI Number 1255881637

LBN Legal business name SOUTHCENTRAL FOUNDATION

Authorized official RONALD OLSON - (EXECUTIVE VICE PRESIDENT FINANCE)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 10/10/2016

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

Identifiers

AK	Medicaid	1664351
AK	Medicaid	1666501

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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