Provider Demographics
NPI:1104979806
Name:MUNICIPALITY OF ANCHORAGE PAYROLL
Entity type:Organization
Organization Name:MUNICIPALITY OF ANCHORAGE PAYROLL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF DHHS
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:INGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-343-6460
Mailing Address - Street 1:PO BOX 196650
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99519-6650
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:825 L ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3337
Practice Address - Country:US
Practice Address - Phone:907-343-6872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2307251K00000X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
No251K00000XAgenciesPublic Health or WelfareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKFP0152Medicaid
AKW00127Medicare UPIN
AKFP0152Medicaid