| Southcentral Foundation | |
|
1008 Main Street Kokhanok AK 99606 | |
| (907) 282-2203 | |
| Not Available |
| Full Name | Southcentral Foundation |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 1008 Main Street, Kokhanok, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (EXECUTIVE VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southcentral Foundation Po Box 35198 Seattle WA 98124-5198 Ph: () - | Southcentral Foundation 1008 Main Street Kokhanok AK 99606 Ph: (907) 282-2203 |
| NPI Number | 1043689169 |
|---|---|
| Provider Enumeration Date | 09/18/2015 |
| Last Update Date | 08/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043689169 | NPI | - | NPPES |
| 1637733 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 20467 (Alaska) | Primary |