Organization
BANNER EXECUTIVE HEALTH LLC
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
PATRICK PENROSE (VP)
(602) 747-4000
Entity
Organization
Contact information
Practice address
4200 E CAMELBACK RD # 102, PHOENIX, AZ 85018-2718
(602) 229-2128
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
02/03/2023
Last updated
04/16/2026
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