Organization
SOUTHCENTRAL FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A MORGAN (DIRECOR OF REIMBURSEMENT)
(907) 729-4955
Entity
Organization
Contact information
Practice address
4501 DIPLOMACY DR, ANCHORAGE, AK 99508-5919
(907) 729-3320
Mailing address
4201 TUDAR CENTRE DR, SUITE 320, ANCHORAGE, AK 99508-5904
(907) 729-8624
(907) 729-8607
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
18317
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18317
STATE OF ALASKA REGISTERED NURSE LICENSE
AK
Enumeration date
07/30/2008
Last updated
09/01/2010
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