SOUTHCENTRAL FOUNDATION NPI 1043689169

NPI Information

  • NPI: 1043689169
  • Provider Name: SOUTHCENTRAL FOUNDATION
  • Classification: Clinic/Center - 261QC1500X
  • Specialization: Community Health
  • Entity Type: Organization
  • Doing Business As: TRIBAL- KOKHANOK COMMUNITY HEALTH CLINIC
  • Address: 1008 MAIN STREET
    KOKHANOK, AK
    ZIP 99606
  • Phone: (907) 282-2203

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NPI Details

SOUTHCENTRAL FOUNDATION is a community health clinic center in Kokhanok, AK. SOUTHCENTRAL FOUNDATION NPI is 1043689169. The provider is registered as an organization entity type.
The provider Is Doing Business As Tribal- Kokhanok Community Health Clinic.

The provider's business location address is:

1008 MAIN STREET
KOKHANOK, AK
ZIP 99606
Phone: (907) 282-2203

The provider's authorized official is Ronald Lee Olson .
The authorized official title is Executive Vice President Of Finance and has the following contact phone number (907) 729-4939.

The enumeration date for this NPI number is 9/18/2015 and was last updated on 8/30/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QC1500XClinic/CenterCommunity Health20467ALASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11637733MEDICAIDALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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