BANNER CHILDRENS BANNER HEALTH CLINIC LLC (NPI# 1558606020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558606020 |
| Entity Type | Organization |
| Organization Name | BANNER CHILDRENS BANNER HEALTH CLINIC LLC |
| Practice Address |
1760 E Florence Blvd Ste 100 Casa Grande AZ 85222-4765 |
| Mailing Address |
1441 N 12th St Phoenix AZ 85006-2837 |
| Practice Telephone | 5204217400 |
| Practice Fax Number | 5204217428 |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2019-11-05 |
| Authorized Official Name | DENNIS DAHLEN (SR VP FINANCE) |
| Authorized Official Telephone | 6027474000 |
| Is Organization Subpart | Y |
| Parent Organization Name | BANNER MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285278077 | Banner Childrens Banner Health Clinic LLC | Clinic/Center | 117 E Main St Ste A100, Payson, AZ 85541-4606 | 2019-11-05 |
| 1407191216 | Banner Childrens Banner Health Clinic LLC | Clinic/Center | 1220 S Higley Rd Ste 101, Mesa, AZ 85206-4001 | 2012-12-05 |
| Street Address |
1760 E FLORENCE BLVD STE 100 |
| City | CASA GRANDE |
| State | AZ |
| Zip Code | 85222-4765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699184093 | Hemali Paton | Pharmacist | 1741 E. Florence Blvd., Casa Grande, AZ 85222 | 2014-08-11 |
| 1023249893 | Krista Marie Nielsen | Nurse Practitioner | 1676 E. Mcmurray Blvd, Cgrmc Urgent Care, Casa Grande, AZ 85222 | 2009-07-28 |
| 1639333479 | Villago Marketplace Dental Care PC | Dentist | 2876 N Pinal Ave, Suite 4, Casa Grande, AZ 85222 | 2008-07-10 |
| 1487811790 | Ashley Vander Weel | Dietitian, Registered | 351 N Peart Rd, Apt 325, Casa Grande, AZ 85222 | 2008-05-22 |
| 1205022787 | Linda C Cassidy | Registered Nurse | 2730 North Trekell Road, Casa Grande Union High School, Casa Grande, AZ 85222 | 2007-09-19 |
| 1104021476 | Jeremy Wade Cull | Dentist | 1876 E Sabin Drive Suite #18, Casa Grande, AZ 85222 | 2007-06-18 |
| 1841404852 | New Horizon Youth Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 467 East Dragon Springs Dr, Casa Grande, AZ 85222 | 2007-05-09 |
| 1013137827 | Namninder S Grn | Dentist | 1677 E Florence Blvd, #24, Casa Grande, AZ 85222 | 2007-04-26 |
| 1528189529 | Jewell Lavoo | Registered Nurse | 129 N Arizola Rd, Casa Grande, AZ 85222 | 2007-04-03 |
| 1922148089 | Martha Dawn Jones-baer | Registered Nurse | 1220 E. Kortsen Dr, Cactus Middle School, Casa Grande, AZ 85222 | 2007-02-07 |
| Find all providers in zip 85222 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
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| 1659970242 | Orthopedic Specialists of North America Pllc | Clinic/Center | 33300 N 32nd Ave, Phoenix, AZ 85085-8877 | 2020-10-23 |
| 1689273542 | Orthopedic Specialists of North America Pllc | Clinic/Center | 33400 N 32nd Ave Fl 1, Phoenix, AZ 85085-8876 | 2020-10-21 |
| 1629676317 | Bethel Hills Integrated Healthcare | Clinic/Center | 13838 S 46th Pl Ste 300, Phoenix, AZ 85044-7804 | 2020-10-14 |
| 1639786585 | Crossover Health Medical Group | Clinic/Center | 1847 E Southern Ave Ste 3, Tempe, AZ 85282-5881 | 2020-09-24 |
| 1821605775 | Crossover Health Medical Group | Clinic/Center | 5251 W Campbell Ave Ste 200, Phoenix, AZ 85031-1719 | 2020-09-24 |
| 1649887597 | Crossover Health Medical Group | Clinic/Center | 8343 W Van Buren St Bldg C-2, Tolleson, AZ 85353-3225 | 2020-09-24 |
| 1235745464 | Vasco Healthcare Inc | Clinic/Center | 2110 W 24th St Ste A, Yuma, AZ 85364-8878 | 2020-09-22 |
| 1265048490 | Vasco Healthcare Inc | Clinic/Center | 8952 E Desert Cove Ave Ste 204, Scottsdale, AZ 85260-6777 | 2020-09-22 |
| 1942816160 | Vasco Healthcare Inc | Clinic/Center | 13026 W Rancho Santa Fe Blvd Ste B100, Avondale, AZ 85392-1712 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
| City | CASA GRANDE |
| Zip Code | 85222 |
Please comment or provide details below to improve the information on BANNER CHILDRENS BANNER HEALTH CLINIC LLC.
| 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.