Banner Arizona Medical Clinic LTD

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

OTC3947 Issued in AZ

Legal business name

BANNER ARIZONA MEDICAL CLINIC LTD

Practice address

14420 W Meeker Blvd
Sun City West, AZ 85375-5286

Phone

(623) 876-5300

Fax

(623) 583-5301

NPI assigned

Mar 9, 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

Margaret Burke

Title

Chief Financial Officer

Phone

(623) 876-3967

Specialties & licenses 2

Addresses

Other identifiers 1

Part of

M E Lee MD

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221782400000",
    "number": "1225169188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13640 N PLAZA DEL RIO BLVD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814846",
            "telephone_number": "623-876-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14420 W MEEKER BLVD",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755286",
            "telephone_number": "623-876-5300",
            "fax_number": "623-583-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER ARIZONA MEDICAL CLINIC LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANNER HEALTH",
        "enumeration_date": "2007-03-09",
        "last_updated": "2008-09-19",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "623-876-3967"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "OTC3947",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "AZ",
            "license": "OTC3947",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "516437",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane R Balderson, PT, DPT
• Salina Nicole Baldwin, D.O.
• Vincent Wayne Baldwin, PT, DPT
• Braxton Ball
• Banner Arizona ASC LLC (Sun City West Ambulatory Surgery Center)
• Banner Arizona Medical Clinic LTD
• Banner Arizona Medical Clinic LTD
• Banner Arizona Medical Clinic, LTD
• Banner del E Webb Medical Center
• Banner del E Webb Medical Center

• Durable Medical Equipment & Medical Supplies in Sun City West, AZ
• Providers in Sun City West, AZ by specialty
• Durable Medical Equipment & Medical Supplies in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; 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.