Southcentral Foundation

NPI #1912954272 in Iliamna, Alaska

Provider Information

NPI Number: 1912954272
Entity Type: Organization
Organization Name: Southcentral Foundation
Subpart: Yes (part of a larger organization)
Parent Organization: SOUTHCENTRAL FOUNDATION
Primary Specialty: Clinic/Center - Multi-Specialty
Enumeration Date: May 30, 2006
Last Updated: Sep 18, 2023

Practice Location

Address: 101 AIRPORT ROAD
City: Iliamna
State: Alaska
ZIP Code: 99606
Phone: (907) 571-1818

Authorized Official

Name: RONALD LEE OLSON
Title: EXECUTIVE VICE PRESIDENT FINANCE
Phone: (907) 729-4939

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Multi-Specialty — Multi-Specialty	261QM1300X	Primary

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