Organization
BANNER COPPER BASIN MEDICAL CLINIC
Active
Organization
BANNER COPPER BASIN MEDICAL CLINIC
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS E DAHLEN (SR VP FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
2474 E HUNT HWY, SUITE 10, QUEEN CREEK, AZ 85143-5210
(480) 543-6680
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
01/13/2009
Last updated
04/11/2011
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