OrganizationActive
Southcentral Foundation
NPI 1760739601 · Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy · Wasilla, AK
Provider details
- NPI number
- 1760739601
- Entity type
- Organization
- Primary specialty
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Ronald Olson, Vp Finance(907) 729-4939
- License
- 20467 (AK)
Specialties & taxonomies
- Indian Health Service/Tribal/Urban Indian Health (I/T/U) PharmacyPrimary332800000XLicense 20467 (AK)
Suppliers
Practice location
1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083
Phone: (907) 631-7800
Fax: (907) 631-7619
Approximate (ZIP-level) locationGet directions
Mailing address
1001 S Knik Goose Bay Rd
Wasilla, AK 99654-8083
Registry dates
- Enumerated
- 2012-08-09
- Last updated
- 2026-06-05
- Certified
- 2026-06-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.