Organization
BANNER PHARMACY SERVICES LLC
Active
Other names
Banner Family Pharmacy - Estrella
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL FUNK (CEO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
9201 W THOMAS RD, PHOENIX, AZ 85037-3332
(623) 327-6170
(623) 327-6171
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
Y005811
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2144997
PK
—
05
—
899765
—
AZ
Enumeration date
12/16/2013
Last updated
04/16/2026
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