Organization
BANNER ARIZONA MEDICAL CLINIC LTD
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
MARGARET BURKE (CHIEF FINANCIAL OFFICER)
(623) 876-3967
Entity
Organization
Contact information
Practice address
13760 N 93RD AVE, PEORIA, AZ 85381-4201
(623) 876-3952
(623) 876-3975
Mailing address
13640 N PLAZA DEL RIO BLVD, PEORIA, AZ 85381-4846
(623) 876-3800
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
OTC3932
AZ
335E00000X
Prosthetic/Orthotic Supplier
OTC3932
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
516437
—
AZ
Enumeration date
03/07/2007
Last updated
09/19/2008
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