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Organization

BANNER HEALTH PHYSICIANS COLORADO LLC

Active
Parent organization
BANNER HEALTH PHYSICIANS COLORADO LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
BANNER HEALTH PHYSICIANS COLORADO LLC
Authorized official
DENNIS LARAWAY (CFO)
(602) 747-4000
Entity
Organization

Contact information

Practice address
2001 70TH AVE STE 110, GREELEY, CO 80634-4628
(970) 810-3011
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
03/13/2020
Last updated
03/13/2020
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