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Organization
FAMILY MEDICAL CENTER
Active
Organization
FAMILY MEDICAL CENTER
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS DAHLEN (SR VP FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
805 E MAIN ST, SUITE A, FERNLEY, NV 89408-9743
(775) 575-7171
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
01/20/2009
Last updated
02/27/2009
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