Organization
BANNER HEALTH
Active
Other names
USAF
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS LARAWAY (CFO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
2017 E RUBY LN, PHOENIX, AZ 85024-8617
(602) 803-9588
(480) 563-2174
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
RN086459
AZ
2865M2000X
Military General Acute Care Hospital
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Other
Enumeration date
04/03/2013
Last updated
01/31/2022
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