Organization · Type 2 NPI

Banner Health

Non-Pharmacy Dispensing Site · Phoenix, AZ

NPI number 1326476813 Active

Practice location

4400 N 32nd St, Suite 140
Phoenix, AZ 85018-3953

Call (602) 553-4848 Map

Mailing address

5626 Oberlin Dr, Suite 110
San Diego, CA 92121-1705

Specialties and licenses

Taxonomy	Code	License
Non-Pharmacy Dispensing Site Primary	332900000X	20737 (AZ)

Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

29 other providers at this address

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NPI record

NPI: 1326476813
Entity type: Organization (Type 2)
Issued: Oct 22, 2013
Last updated: Jan 31, 2022
Status: Active
Subpart: Yes of Medvantx, Inc.

Other names

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Banner Health Clinic-32nd ST Internal Medicine · doing business as
Banner Health Clinic-32nd ST Internal Medicine · doing business as

Authorized official

Dennis Laraway
CFO
(602) 747-4000

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1326476813

Banner Health's National Provider Identifier is 1326476813, issued on Oct 22, 2013. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Phoenix, AZ. The record was last updated on Jan 31, 2022.