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 1432 S Dobson Rd , Mesa AZ 85202-4768. 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 Physician Super Specialists Arizona Llc can be contacted via phone (480) 412-4100, or through Laraway, Dennis via phone (602) 747-4000.

Contact Information

Primary practice address
1432 S Dobson Rd Mesa AZ 85202-4768
Phone: (480) 412-4100
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Laraway, Dennis
Phone: (602) 747-4000

Health care specialties

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

Profile Details

NPI number 1841573870
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 Sep 26th, 2011
Last updated Dec 28th, 2021 - about 3 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 1841573870 NPPES
Arizona MEDICAID 646532

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