Organization
NOCO NEWCO, LLC
Active
Parent organization
BANNER MEDICAL GROUP COLORADO
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER MEDICAL GROUP COLORADO
Authorized official
DENNIS LAROWAY (CFO)
(602) 747-4000
Entity
Organization
Contact information
Practice address
2010 16TH ST STE A, GREELEY, CO 80631-5188
(970) 810-4475
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
12/10/2018
Last updated
12/23/2021
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