Banner Physician Super Specialists Arizona Llc

LBN: Banner Physician Super Specialists Arizona Llc
Banner Physician Super Specialists Arizona Llc is an health care organization with primary practice located at 1450 S Dobson Rd Ste B221 , Mesa AZ 85202-4745. The organization recently has 2 registered licenses in different health care specialties including Dietary & Nutritional Service Providers / Nutrition, Education, Ambulatory Health Care Facilities / Multi-Specialty. Dietary & Nutritional Service Providers / Nutrition, Education is the primary health care specialty. Banner Physician Super Specialists Arizona Llc can be contacted via phone (480) 827-5370, or through Laraway, Dennis via phone (602) 747-4000.

Contact Information

Primary practice address
1450 S Dobson Rd Ste B221 Mesa AZ 85202-4745
Phone: (480) 827-5370
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Laraway, Dennis
Phone: (602) 747-4000

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Education 133NN1002X
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X

Profile Details

NPI number 1790337665
LBN Legal business name Banner Physician Super Specialists Arizona Llc
DBA Doing business as
Authorized official Laraway, Dennis
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 11th, 2019
Last updated Dec 28th, 2021 - about 5 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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