Organization
COMMUNITY HOSPITAL
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
INGRID T LONG (CEO)
(307) 532-2107
Entity
Organization
Contact information
Practice address
625 ALBANY AVE, TORRINGTON, WY 82240-1530
(307) 532-2107
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
(602) 747-4000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/22/2024
Last updated
08/30/2024
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