Organization
BANNER HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK PENROSE (VP)
(602) 747-4000
Entity
Organization
Contact information
Practice address
1255 E C ST, CASPER, WY 82601-2182
(307) 577-2023
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
04/16/2026
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