Organization
FAMILY CARE CLINIC
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
MATTHEW COX (SR VICE PRESIDENT FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
615 FAIRHURST ST, STERLING, CO 80751-4523
(970) 521-3223
Mailing address
2901 N CENTRAL AVE, STE 160, PHOENIX, AZ 85012
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05575541
—
CO
Enumeration date
06/26/2006
Last updated
06/06/2017
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