Organization · Type 2 NPI

Southcentral Foundation

Community Health Clinic/Center · Nondalton, AK

NPI number 1740659192 Active

Practice location

69 Main Street
Nondalton, AK 99640

Call (907) 294-2238 Map

Mailing address

PO Box 35198
Seattle, WA 98124-5198

Specialties and licenses

Taxonomy	Code	License
Community Health Clinic/Center Primary	261QC1500X	20467 (AK)

Community Health Clinic/Center: Definition to come...

4 other providers at this address

Southcentral FoundationGeneral Practice Dentistry Nondalton, AK NPI 1013464916
Southcentral FoundationCommunity/Behavioral Health Agency Nondalton, AK NPI 1639772882
Gloria M. TrefonCommunity Health Worker Nondalton, AK NPI 1649829797
Karina A. Jeffries, CHA IIICommunity Health Worker Nondalton, AK NPI 1598519217

NPI record

NPI: 1740659192
Entity type: Organization (Type 2)
Issued: Sep 16, 2015
Last updated: Sep 14, 2023
Status: Active
Subpart: Yes of Southcentral Foundation

Other names

<unavail>
Tribal- Nondalton Clinic · doing business as

Authorized official

Ronald Lee Olson
Executive Vice President Finance
(907) 729-4939

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1740659192

Southcentral Foundation's National Provider Identifier is 1740659192, issued on Sep 16, 2015. The primary taxonomy on file is Community Health Clinic/Center (261QC1500X), and the practice location is in Nondalton, AK. The record was last updated on Sep 14, 2023.