Organization
NCMC SPECIALTY CLINIC
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
ALAN QUALLS (CEO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1801 16TH ST, GREELEY, CO 80631-5154
(970) 378-4475
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93588321
—
CO
Enumeration date
06/30/2006
Last updated
10/28/2024
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