Organization
BANNER FAMILY PHARMACY
Active
Other names
Banner Family Pharmacy - Estrella
Organization subpart
No
Provider details
NPI number
Authorized official
DEB KRMPOTIC RPH (CEO)
(623) 327-5001
Entity
Organization
Contact information
Practice address
9201 W THOMAS RD, PHOENIX, AZ 85037-3332
(623) 327-6170
(623) 327-6171
Mailing address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(623) 327-6170
(623) 327-6171
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
Y005712
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142167
PK
—
05
—
851577
—
AZ
Enumeration date
09/24/2013
Last updated
12/06/2013
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