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Organization
BANNER - UNIVERSITY MEDICAL CENTER SOUTH CAMPUS LLC
Active
Organization
BANNER - UNIVERSITY MEDICAL CENTER SOUTH CAMPUS LLC
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS LARAWAY (CFO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
3950 S COUNTRY CLUB RD STE 130&140, TUCSON, AZ 85714-2099
(520) 874-4800
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
—
NULL
133NN1002X
Nutrition Education Nutritionist
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
NULL
Other
Enumeration date
07/08/2019
Last updated
02/09/2022
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