| Southcentral Foundation | |
|
1000 Polovina Turnpike St Paul AK 99660 | |
| (907) 546-2310 | |
| Not Available |
| Full Name | Southcentral Foundation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1000 Polovina Turnpike, St Paul, Alaska |
| Authorized Official Name and Position | Ronald L Olson (VP FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southcentral Foundation 4501 Diplomacy Dr Attn: Provider Enrollment Services Anchorage AK 99508-5919 Ph: () - | Southcentral Foundation 1000 Polovina Turnpike St Paul AK 99660 Ph: (907) 546-2310 |
| NPI Number | 1831596311 |
|---|---|
| Provider Enumeration Date | 11/26/2014 |
| Last Update Date | 07/12/2024 |
| Certification Date | 07/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831596311 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |