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Organization
BANNER GOOD SAMARITAN
Active
Organization
BANNER GOOD SAMARITAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS LARAWAY (CFO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1441 NORTH 12TH STREET, PHOENIX, AZ 85006
(602) 239-2296
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
R1035
AZ
Other
Enumeration date
06/30/2008
Last updated
01/31/2022
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