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Organization

FAIRBANKS MEMORIAL CARDIOLOGY CENTER, LLC

Active
Parent organization
FOUNDATION HEALTH LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
FOUNDATION HEALTH LLC
Authorized official
ANTHONY G SUDUTH CPA, FHFMA, FACHE (CFO)
(907) 458-3310
Entity
Organization

Contact information

Practice address
1650 COWLES ST DEPT 60A, FAIRBANKS, AK 99701-5907
(907) 458-5525
Mailing address
1650 COWLES ST DEPT 60A, FAIRBANKS, AK 99701-5907
(907) 458-5525

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
261QM2500X
Medical Specialty Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1656021
AK
Enumeration date
09/29/2016
Last updated
04/14/2026
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