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Organization

BANNER HOSPITAL BASED PHYSICIANS WEST LLC

Active
Parent organization
BANNER HEALTH
Organization subpart
Yes

Provider details

NPI number
Legal business name
BANNER HEALTH
Authorized official
SHIVA BIRDI (CEO)
(602) 747-4000
Entity
Organization

Contact information

Practice address
801 E WILLIAMS AVE, FALLON, NV 89406-3052
(775) 423-3151
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
(602) 747-4000

Taxonomy

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

Other

Enumeration date
02/19/2025
Last updated
02/19/2025
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