BANNER ARIZONA MEDICAL CLINIC LTD (NPI# 1578694055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578694055 |
| Entity Type | Organization |
| Organization Name | BANNER ARIZONA MEDICAL CLINIC LTD |
| Practice Address |
13640 N Plaza Del Rio Blvd Peoria AZ 85381-4846 |
| Practice Telephone | 6238763800 |
| Mailing Telephone | 6238763800 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2008-09-19 |
| Authorized Official Name | MARGARET BURKE (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6238763967 |
| Is Organization Subpart | Y |
| Parent Organization Name | BANNER HEALTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 335E00000X | Prosthetic/Orthotic Supplier | OTC3936 | AZ | Suppliers |
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | OTC3936 | AZ | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 516437 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780715698 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 9165 W Thunderbird Road, Peoria, AZ 85381 | 2007-03-09 |
| 1952432866 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 14416 W Meeker Blvd, Sun City West, AZ 85375-5284 | 2007-03-09 |
| 1225169188 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 14420 W Meeker Blvd, Sun City West, AZ 85375-5286 | 2007-03-09 |
| 1245361773 | Banner Arizona Medical Clinic Ltd | Clinical Medical Laboratory | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2007-03-08 |
| 1447381207 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 14418 W Meeker Blvd, Sun City West, AZ 85375-5283 | 2007-03-07 |
| 1568593325 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 10401 W Thunderbird Blvd, Ste 209, Sun City, AZ 85351-3004 | 2007-03-07 |
| 1487785002 | Banner Arizona Medical Clinic Ltd | Prosthetic/Orthotic Supplier | 13760 N 93rd Ave, Peoria, AZ 85381-4201 | 2007-03-07 |
| 1750347936 | Banner Arizona Medical Clinic Ltd | Clinic/Center | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2006-04-25 |
| Street Address |
13640 N PLAZA DEL RIO BLVD |
| City | PEORIA |
| State | AZ |
| Zip Code | 85381-4846 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649279654 | John Peter Kieley | Internal Medicine | 13640 N Plaza Del Rio Blvd, Suite 220, Peoria, AZ 85381-4846 | 2005-07-20 |
| 1366913618 | Krishna Keshav | Nurse Practitioner | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381 | 2018-12-16 |
| 1871062158 | Samantha Mae Boartfield | Pharmacist | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2018-11-16 |
| 1790236487 | Israa Al-sayyed | Physician Assistant | 13640 N Plaza Del Rio Blvd, Ste 340, Peoria, AZ 85381-4846 | 2016-10-18 |
| 1326408444 | Banner Pharmacy Services LLC | Pharmacy | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2016-03-02 |
| 1801278981 | Shin Jung Yoon | Family Medicine | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381 | 2015-06-24 |
| 1831584044 | Michelle Obillo Prestoza | Family Medicine | 13640 N Plaza Del Rio Blvd, Peoria, AZ 85381-4846 | 2015-04-03 |
| 1578967162 | Tina Marino | Nurse Practitioner | 13640 N Plaza Del Rio Blvd, Suite 230, Peoria, AZ 85381-4846 | 2014-10-10 |
| 1396156139 | Banner Health | Non-Pharmacy Dispensing Site | 13640 N Plaza Del Rio Blvd, 3rd Floor, Suite 350, Peoria, AZ 85381-4846 | 2014-05-14 |
| 1932522836 | Deborah L. Burns | Registered Nurse | 13640 N Plaza Del Rio Blvd, 210, Peoria, AZ 85381-4846 | 2014-01-28 |
| Find all providers in the same location | ||||
| 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 | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528690112 | Sg Mechanical LLC | Durable Medical Equipment & Medical Supplies | 8550 N 91st Ave Ste E-51, Peoria, AZ 85345-8311 | 2020-02-11 |
| 1285272435 | Margaret A. Withrow, Dpm, PC | Durable Medical Equipment & Medical Supplies | 13660 N 94th Dr Ste A3, Peoria, AZ 85381-4836 | 2019-12-18 |
| 1003462581 | Bump Boxes, Inc | Durable Medical Equipment & Medical Supplies | 7719 N Pioneer Ln, Peoria, IL 61615-1910 | 2019-08-12 |
| 1023663010 | Kokopelli Eye Care PC | Durable Medical Equipment & Medical Supplies | 9151 W Thunderbird Rd Ste 104, Peoria, AZ 85381-4906 | 2019-08-06 |
| 1851943286 | Banner Home Care Arizona | Durable Medical Equipment & Medical Supplies | 14131 N Rio Vista Blvd Ste 7, Peoria, AZ 85381-4917 | 2019-07-16 |
| 1093370108 | Osf Healthcare System | Durable Medical Equipment & Medical Supplies | 1800 N Knoxville Ave Ste 104, Peoria, IL 61603-3028 | 2019-05-03 |
| 1023584810 | Homestead Orthotics LLC | Durable Medical Equipment & Medical Supplies | 9401 W Thunderbird Rd Ste 187, Peoria, AZ 85381-4210 | 2018-10-18 |
| 1326552977 | Triage Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 10434 W Redbird Rd, Peoria, AZ 85383-3578 | 2017-11-17 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1144695883 | Game Day Medical, LLC | Durable Medical Equipment & Medical Supplies | 3004 W Playden Dr, Peoria, IL 61615-7505 | 2015-12-07 |
| 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.