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Organization
SOUTHCENTRAL FOUNDATION
Active
Organization
SOUTHCENTRAL FOUNDATION
Active
Parent organization
SOUTHCENTRAL FOUNDATION
Other names
Tribal - KKGB ANTHC (Shared)
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHCENTRAL FOUNDATION
Authorized official
RONALD LEE OLSON (EXECUTIVE VICE PRESIDENT FINANCE)
(907) 729-4939
Entity
Organization
Contact information
Practice address
4441 DIPLOMACY DR, ANCHORAGE, AK 99508-5910
(907) 729-4955
Mailing address
PO BOX 35198, SEATTLE, WA 98124-5198
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
20467
AK
Other
Enumeration date
03/22/2018
Last updated
04/04/2025
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