Tribal - Pedro Bay Community Health Clinic

LBN: Southcentral Foundation
Tribal - Pedro Bay Community Health Clinic is an health care organization with primary practice located at 2516 Mountain Circle , Pedro Bay AK 99647. The organization recently has only one registered license in Ambulatory Health Care Facilities / Community Health, which is considered as the primary health care specialty. Southcentral Foundation can be contacted via phone (907) 850-2229, or through Olson, Ronald Lee via phone (907) 729-4939.

Contact Information

Primary practice address
2516 Mountain Circle Pedro Bay AK 99647
Fax:
Website:
Authorized official contact:
Name: Olson, Ronald Lee

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Community Health 261QC1500X 20467 Alaska

Profile Details

NPI number 1952770307
LBN Legal business name Southcentral Foundation
DBA Doing business as Tribal - Pedro Bay Community Health Clinic
Authorized official Olson, Ronald Lee
Entity Organization
Organization subpart 1 Yes
Enumeration date Sep 16th, 2015
Last updated Sep 19th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952770307 NPPES
Alaska MEDICAID 1637731

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