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
1	261QM1300X	Multi-Specialty Clinic/Center
2	261QP2300X	Primary Care Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number	:	1487608659
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	:	4000 LAUREL ST
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-5333
Country	:	US
Telephone Number	:	907-729-6300
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE VICE PRESIDENT FINANCE
Name	:	RONALD LEE OLSON
Credential	:
Telephone Number	:	907-729-4939

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	04/19/2024

Similar Medicare Providers

1912013160 — DIALYSIS ASSOCIATES OF ALASKA, LLC
Practice Location Address:

3950 LAUREL ST
ANCHORAGE, AK
99508-5333

Practice Phone: 907-261-4840
Practice Fax: 469-833-4858

1902877251 — MICHELE O'FALLON M.D.
Practice Location Address:

4048 LAUREL ST
ANCHORAGE, AK
99508-5333

Practice Phone: 907-770-7800
Practice Fax: 907-929-4660

1710958061 — LAURIE MONTANO M.D.
Practice Location Address:

4048 LAUREL ST
ANCHORAGE, AK
99508-5333

Practice Phone: 907-770-7800
Practice Fax: 907-929-4660

1508835299 — ALASKA DIGESTIVE CENTER, LLC
Practice Location Address:

4048 LAUREL ST , SUITE 103A
ANCHORAGE, AK
99508-5333

Practice Phone: 907-563-1750
Practice Fax: 907-550-4403

1528094968 — MELODIE ISGRO MD
Practice Location Address:

4000 LAUREL ST
ANCHORAGE, AK
99508-5333

Practice Phone: 907-729-6300
Practice Fax: 907-729-6314

1922146307 — SHANE BALL LPC
Practice Location Address:

4000 LAUREL ST
ANCHORAGE, AK
99508-5333

Practice Phone: 907-729-6300
Practice Fax:

Directions to “SOUTHCENTRAL FOUNDATION ” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.