BANNER UMC DPEC


Address: 3950 S Country Club Road, Suite 130, Tucson, AZ 85714
Phone: 5208742000

BANNER UMC DPEC (NPI# 1356790158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1356790158
Entity Type Organization
Organization Name BANNER UMC DPEC
Practice Address 3950 S Country Club Road
Suite 130
Tucson
AZ 85714
Mailing Address 3950 S Country Club Road
130
Tucson
AZ 85714
Practice Telephone 5208742000
Practice Fax Number 5208744801
Mailing Telephone 5208742000
Mailing Fax Number 5208744801
Enumeration Date 2016-06-13
Last Update Date 2016-06-13
Authorized Official Name MERRI PENDERGRASS (PHYSICIAN)
Authorized Official Telephone 5206266376
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 133NN1002X Nutritionist
Specialization: Nutrition, Education
942958258 AZ Dietary & Nutritional Service Providers

Office Location

Street Address 3950 S COUNTRY CLUB ROAD
SUITE 130
City TUCSON
State AZ
Zip Code 85714

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Taxonomy Information

Taxonomy Code 133NN1002X
Grouping Dietary & Nutritional Service Providers
Classification Nutritionist
Specialization Nutrition, Education

Taxonomy Definition

Definition to come...

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1619219631 Eastside Nutrition LLC Nutritionist 333 N Wilmot Rd, Suite 340, Tucson, AZ 85711-2631 2013-03-18
1558665398 Armando Valdez De Guzman Nutritionist 9420 E Golf Links Rd, Suite 108-296, Tucson, AZ 85730-1355 2011-01-10

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NPI Name Taxonomy Address Enumeration
1538780598 Penny Jean Stadick Nutritionist 20259 N Ryans Trl, Maricopa, AZ 85138-2446 2020-04-30
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1285143115 Charles Higgins Jr. Nutritionist 600 N 4th St Apt 272, Phoenix, AZ 85004-4485 2017-09-22
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1639622434 Jenny Woelk Nutritionist 2757 S Pewter Dr, 102, Gilbert, AZ 85295-1282 2016-07-27
1053783829 Debra L Mcdaniel-perez Nutritionist 28784 E Aster Ln, Marana, AZ 85658-9223 2015-10-20
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1790190155 Rustom Ali Nutritionist 1968 Mesquite Ave, Lake Havasu City, AZ 86403-5729 2014-06-24
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Competitor

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City TUCSON
Zip Code 85714

Improve Information

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Dataset Information

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.

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