Organization
BANNER THUNDERBIRD MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS LARAWAY (CFO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
5555 W THUNDERBIRD RD, GLENDALE, AZ 85306-4622
(602) 865-5555
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
—
—
Other
Enumeration date
01/23/2007
Last updated
12/27/2021
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