Organization
SOUTHCENTRAL FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD LEE OLSEN (VP OF FINANCE)
(907) 729-4949
Entity
Organization
Contact information
Practice address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(907) 729-8624
Mailing address
4501 DIPLOMACY DR, ANCHORAGE, AK 99508-5919
(907) 729-8624
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
20467
AK
Other
Enumeration date
09/22/2016
Last updated
09/22/2016
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