Organization
BANNER GOOD SAMARITAN BARIATRIC PROGRAM
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS DAHLEN (SR VICE PRESIDENT - FINANCE)
(602) 495-4000
Entity
Organization
Contact information
Practice address
1300 N 12TH ST, PHOENIX, AZ 85006-2850
(602) 239-5000
(602) 239-3339
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
810871
—
AZ
Enumeration date
05/18/2006
Last updated
10/15/2007
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