Provider Demographics
NPI:1154706810
Name:ALASKA DINNER FACTORY, INC.
Entity type:Organization
Organization Name:ALASKA DINNER FACTORY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINNEA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-677-6633
Mailing Address - Street 1:5905 LAKE OTIS PKWY
Mailing Address - Street 2:UNIT E
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1700
Mailing Address - Country:US
Mailing Address - Phone:907-677-6633
Mailing Address - Fax:907-677-6636
Practice Address - Street 1:5905 LAKE OTIS PKWY
Practice Address - Street 2:UNIT E
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1700
Practice Address - Country:US
Practice Address - Phone:907-677-6633
Practice Address - Fax:907-677-6636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKHCX332U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKHCXOtherSTATE OF ALASKA, SENIOR AND DISABILITIES SERVICES