Organization
BANNER HEALTH
Active
Parent organization
MEDVANTX, INC.
Other names
Banner Health Clinic- Tempe
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
DENNIS LARAWAY (CFO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
2600 E SOUTHERN AVE, SUITE B2, TEMPE, AZ 85282-7610
(480) 730-5100
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
34858
AZ
Other
Enumeration date
10/22/2013
Last updated
01/31/2022
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