Organization
B--UMCP SUPER SPECIALISTS LLC
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS DAHLEN (SR VP FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1300 N 12TH ST STE 404, PHOENIX, AZ 85006-2866
(602) 839-7000
Mailing address
2901 N CENTRAL AVE, PHOENIX, AZ 85012-2700
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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