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Organization

BANNER - UNIVERSITY HOSPITAL BASED PHYSICIANS LLC

Active
Parent organization
BANNER -- UNIVERSITY MEDICAL GROUP
Organization subpart
Yes

Provider details

NPI number
Legal business name
BANNER -- UNIVERSITY MEDICAL GROUP
Authorized official
VENKATA EVANI (CEO)
(602) 258-1519
Entity
Organization

Contact information

Practice address
1111 E MCDOWELL RD, PHOENIX, AZ 85006-2612
(602) 839-2000
Mailing address
2901 N CENTRAL AVE STE 160, PHOENIX, AZ 85012-2702
(602) 747-4000

Taxonomy

Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
282N00000X
General Acute Care Hospital

Other

Enumeration date
05/25/2023
Last updated
05/25/2023
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