BANNER PEORIA SURGERY CENTER LLC (NPI# 1104341353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104341353 |
| Entity Type | Organization |
| Organization Name | BANNER PEORIA SURGERY CENTER LLC |
| Practice Address |
13640 N Plaza Del Rio Blvd Ste 135 Peoria AZ 85381-4846 |
| Mailing Address |
2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 |
| Practice Telephone | 6232344766 |
| Practice Fax Number | 6028013657 |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2019-07-26 |
| Authorized Official Name | MATTHEW COX (SR VP FINANCE) |
| Authorized Official Telephone | 6027474000 |
| Is Organization Subpart | Y |
| Parent Organization Name | BANNER HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Street Address |
13640 N PLAZA DEL RIO BLVD STE 135 |
| City | PEORIA |
| State | AZ |
| Zip Code | 85381-4846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712122 | Vicki L Grenier | Registered Nurse | 7558 W. Thunderbird Rd. Ste 1-507, Peoria, AZ 85381 | 2020-08-26 |
| 1568934107 | Earthwalk Wellness Group, LLC | Social Worker | 14050 North 83rd Avenue, Suite 290, Peoria, AZ 85381 | 2018-12-20 |
| 1316412059 | John & Biljana Feeley Dba J & B Assisted Living IIi Inc | Community Based Residential Treatment Facility, Mental Illness | 7331 W Sweetwater Avenue, Peoria, AZ 85381 | 2018-10-09 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1083112106 | Marissa Lynn Desjardins | Physical Therapist | 8240 W. Cactus Rd. Oakeson Physical Therapy, Peoria, AZ 85381 | 2018-01-23 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1457897027 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 7524 W. Alexandria Way, Peoria, AZ 85381 | 2017-01-06 |
| 1386023448 | Scott Boone | Registered Nurse | 7715 W Watson Ln, Peoria, AZ 85381 | 2015-05-22 |
| 1881084838 | Pinnacle Women's Center LLC | Obstetrics & Gynecology | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381 | 2015-01-29 |
| 1245637081 | Kathi Locke | Counselor | 13460 N. 94th Drive, Suite J2, Peoria, AZ 85381 | 2014-11-21 |
| Find all providers in zip 85381 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285085068 | Valley Pain Centers of Arizona, LLC | Clinic/Center | 9242 W Union Hills Dr Ste 100, Peoria, AZ 85382-8218 | 2016-06-23 |
| 1700137650 | Olive Surgical Care, LLC | Clinic/Center | 8914 N 91st Ave, Suite 120, Peoria, AZ 85345-8390 | 2012-10-01 |
| 1972782845 | Nationalhealthcareinc | Clinic/Center | 7405 N University St, Peoria, IL 61614-1212 | 2007-10-29 |
| 1104957869 | Pain Solutions Center, LLC | Clinic/Center | 15262 N 75th Ave, Suite 400, Peoria, AZ 85381-4763 | 2007-03-07 |
| 1821141284 | Center for Health Ambulatory Surgery Center, LLC | Clinic/Center | 8800 Route 91 North, Peoria, IL 61615 | 2007-01-19 |
| 1528002219 | Pinnacle Surgery Center LLC | Clinic/Center | 6790 W Thunderbird Rd, Peoria, AZ 85381-5023 | 2006-06-15 |
| 1518498385 | Annmarie Klein | Clinic/Center | 530 Ne Glen Oak Ave, Peoria, IL 61637-0001 | 2017-03-23 |
| 1023567260 | Ski Ambulatory Surgical Centers, LLC | Clinic/Center | 7362 W Thunderbird Rd, Suite 103, Peoria, AZ 85381-5028 | 2016-09-29 |
| 1790104248 | Metro Surgery Center, LLC | Clinic/Center | 6790 W Thunderbird Rd, Peoria, AZ 85381 | 2014-04-14 |
| 1942624622 | Olive Surgical Care, LLC | Clinic/Center | 8914 N 91st Ave, Suite 100-a, Peoria, AZ 85345-8396 | 2014-02-14 |
| Find all providers in PEORIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.