Organization
BANNER PHYSICIAN SUPER SPECIALISTS ARIZONA LLC
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
SHIVA BIRDI (CEO BMG)
(602) 747-4000
Entity
Organization
Contact information
Practice address
5601 W EUGIE AVE STE 100, GLENDALE, AZ 85304-1256
(602) 865-4510
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
(602) 747-4000
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/30/2024
Last updated
10/30/2024
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