SOUTHCENTRALFOUNDATION; NPI #1750052387

Contact Information

SOUTHCENTRALFOUNDATION

3223 E PALMER WASILLA HWY STE 4
WASILLA, AK 99654-7277

Phone: 907-729-6799
Fax: 907-729-8607
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Multi-Specialty	261QM1300X	70	Clinic or Group Practice

Indicates primary specialty

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NPI Profile & details for SOUTHCENTRALFOUNDATION

NPI #	`1750052387`
LBN Legal business name	SOUTHCENTRALFOUNDATION
Authorized official	JONA TETZLOFF - (MANAGER)
Entity	Organization
Organization subpart ¹	No
Enumeration date	09/23/2021
Last updated	05/19/2025 - More than a year ago
Identifiers	n/a

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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