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NPI Code Detail

MEDICARE: SOUTHCENTRAL FOUNDATION

MEDICARE: SOUTHCENTRAL FOUNDATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0400XRehabilitation Clinic/Center20467AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144274986
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHCENTRAL FOUNDATION
Provider Business Mailing Address
First Line : PO BOX 35198
Second Line :
City : SEATTLE
State : WA
Zip : 98124-5198
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 225 EAGLE ST
Second Line :
City : ANCHORAGE
State : AK
Zip : 99501-2626
Country : US
Telephone Number : 907-729-6550
Fax Number :
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT FINANCE
Name : RONALD LEE OLSON
Credential :
Telephone Number : 907-729-4939
Provider Enumeration Date : 05/19/2006
Last Update Date : 08/31/2023

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Directions to “SOUTHCENTRAL FOUNDATION ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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