Organization
BANNER PHARMACY SERVICES LLC
Active
Other names
Banner Family Pharmacy - Thunderbird
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL FUNK (CEO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
5555 W THUNDERBIRD RD, GLENDALE, AZ 85306-4622
(602) 865-2378
(602) 865-2373
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
(602) 747-4000
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
Y005804
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2145017
PK
—
05
—
895445
—
AZ
Enumeration date
12/16/2013
Last updated
04/15/2026
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