Organization
BANNER ARIZONA MEDICAL CLINIC LTD
Active
Organization
BANNER ARIZONA MEDICAL CLINIC LTD
Active
Parent organization
BANNER HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
BANNER HEALTH
Authorized official
DENNIS DAHLEN (SR VICE PRESIDENT - FINANCE)
(602) 747-4000
Entity
Organization
Contact information
Practice address
13640 N PLAZA DEL RIO BLVD, PEORIA, AZ 85381-4846
(623) 876-3800
(623) 972-9590
Mailing address
13640 N PLAZA DEL RIO BLVD, PEORIA, AZ 85381-4846
(623) 876-3800
(623) 972-9590
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
OTC3936
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0516437
—
AZ
Enumeration date
04/25/2006
Last updated
12/03/2008
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