Banner Desert Medical Center

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

BANNER DESERT MEDICAL CENTER

Doing business as

Jewels Garden Oncology Boutique

Practice address

1400 S Dobson Rd
Oncology Gift Shop, Room 1053
Mesa, AZ 85202-4707

Phone

(480) 412-5959

NPI assigned

Jan 30, 2007

Organization subpart

Yes

Parent organization

BANNER HEALTHAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Dennis Laraway

Title

Cfo

Phone

(602) 747-4000

Specialties & licenses 1

Addresses

Other names 1

• Jewels Garden Oncology Boutique Doing business as

Part of

M E Lee MD

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Banner Health

  dba Banner Payson Medical Center

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1174660435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 N CENTRAL AVE STE 160",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S DOBSON RD",
            "address_2": "ONCOLOGY GIFT SHOP, ROOM 1053",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024707",
            "telephone_number": "480-412-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER DESERT MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2007-01-30",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A",
        "authorized_official_last_name": "LARAWAY",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "602-747-4000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jewels Garden Oncology Boutique",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jewels Garden Oncology Boutique",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Banner Baywood Medical Center (John J. Rhodes Rehabilitation Institute)
• Banner Baywood Surgery Center, LP
• Banner Behavioral Health - East Valley
• Banner Cardio-Thoracic and Vascular Specialists
• Banner Childrens Specialists
• Banner Desert Medical Center
• Banner Desert Medical Center
• Banner Desert Medical Center (Banner Desert Care Center)
• Banner Desert Medical Center
• Banner Desert Outpatient Pharmacy

• Prosthetic/Orthotic Supplier in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Prosthetic/Orthotic Supplier in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.