Organization
BREAST CANCER DETECTION CENTER OF ALASKA AND CHARITABLE CORPORATION
Active
Other names
BCDC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ODETTE BUTLER (EXECUTIVE DIRECTOR)
(907) 479-3909
Entity
Organization
Contact information
Practice address
1905 COWLES ST, FAIRBANKS, AK 99701-5914
(907) 479-3909
(907) 479-2215
Mailing address
1905 COWLES ST, FAIRBANKS, AK 99701-5914
(907) 479-3909
(907) 479-2215
Taxonomy
Speciality
Code
Description
License number
State
261QR0206X
Mammography Clinic/Center
Primary
235774
AK
261QR0207X
Mobile Mammography Clinic/Center
235774
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149193
BLUE CROSS
AK
05
—
XR5382
—
AK
Enumeration date
01/19/2007
Last updated
10/08/2013
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