# BANNER DESERT MEDICAL CENTER

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Banner Desert Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780739631
- **Authorized official:** DENNIS LARAWAY (CFO)
- **Authorized official phone:** (602) 747-4000

## Contact information

- **Practice address:** 2145 W SOUTHERN AVE, MESA, AZ 85202-4715
- **Practice address phone:** (480) 890-4800
- **Mailing address:** 2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 01/23/2007
- **Last updated:** 01/13/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 538712 | — | AZ |