Organization
BANNER PHARMACY SERVICES LLC
Active
Organization
BANNER PHARMACY SERVICES LLC
Active
Other names
Banner Family Pharmacy - Boswell
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL FUNK (CEO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
10401 W THUNDERBIRD BLVD STE 100, SUN CITY, AZ 85351-3004
(623) 465-6090
(623) 465-6085
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
Y006822
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146715
—
AZ
01
—
2159705
PK
—
Enumeration date
03/02/2016
Last updated
04/16/2026
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