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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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