Organization
SOUTHCENTRAL FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD LEE OLSON (VP FINANCE)
(907) 729-4939
Entity
Organization
Contact information
Practice address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(907) 631-7800
(907) 631-7619
Mailing address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(907) 631-7800
(907) 631-7619
Taxonomy
Speciality
Code
Description
License number
State
332800000X
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Primary
20467
AK
Other
Enumeration date
08/09/2012
Last updated
08/21/2014
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