Organization
BANNER FAMILY PHARMACY
Active
Other names
Banner Family Pharmacy Desert
Organization subpart
No
Provider details
NPI number
Authorized official
EVELIN ROBLES (PHCY OPS SENIOR MANAGER)
(480) 412-4250
Entity
Organization
Contact information
Practice address
1400 S DOBSON RD, MESA, AZ 85202-4707
(480) 412-4250
(480) 412-4252
Mailing address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(602) 839-2000
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
Y005805
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142567
PK
—
05
—
863491
—
AZ
Enumeration date
10/16/2013
Last updated
01/31/2014
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