Organization
BANNER THUNDERBIRD SURGICENTER
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS DAHLEN (SR VICE PRESIDENT FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
5555 - B WEST THUNDERBIRD ROAD, GLENDALE, AZ 85306
(602) 865-5475
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OSC 3775
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
969719
—
AZ
Enumeration date
06/28/2006
Last updated
01/09/2008
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