Banner Good Samaritan Outpatient Clinic

LBN: Banner Good Samaritan Outpatient Clinic
Banner Good Samaritan Outpatient Clinic is an health care organization with primary practice located at 925 E Mcdowell Rd , Phoenix AZ 85006-2502. The organization recently has only one registered license in Ambulatory Health Care Facilities / Multi-Specialty, which is considered as the primary health care specialty. Banner Good Samaritan Outpatient Clinic can be contacted via phone (602) 239-4777, or through Dahlen, Dennis E via phone (602) 747-4000.

Contact Information

Primary practice address
925 E Mcdowell Rd Phoenix AZ 85006-2502
Phone: (602) 239-4777
Fax: (602) 239-5806
Website:
Map and Directions
Authorized official contact:
Name: Dahlen, Dennis E
Phone: (602) 747-4000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1609829019
LBN Legal business name Banner Good Samaritan Outpatient Clinic
DBA Doing business as
Authorized official Dahlen, Dennis E
Entity Organization
Organization subpart 1 Yes
Enumeration date May 18th, 2006
Last updated Oct 15th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609829019 NPPES
Arizona MEDICAID 767824

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