Organization
BANNER CANCER CENTER SPECIALISTS COLORADO LLC
Active
Parent organization
BANNER MEDICAL GROUP COLORADO
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER MEDICAL GROUP COLORADO
Authorized official
DENNIS LARAWAY (CFO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1801 16TH ST, GREELEY, CO 80631-5154
(970) 810-4121
(970) 350-6140
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
261QX0200X
Oncology Clinic/Center
Primary
—
—
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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