Organization
SOUTHCENTRAL FOUNDATION MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL SHERRY (CEO)
(907) 729-1905
Entity
Organization
Contact information
Practice address
4155 TUDOR CENTRE DR STE 103, ATTN SHERRY REEDY, ANCHORAGE, AK 99508-5912
(907) 729-3971
(907) 729-1572
Mailing address
4155 TUDOR CENTRE DR STE 103, ATTN SHERRY REEDY, ANCHORAGE, AK 99508-5912
(907) 729-3971
(907) 729-1572
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
20467
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MS4320
—
AK
Enumeration date
05/22/2007
Last updated
08/22/2020
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