Banner Health Physicians West LLC
Organization Active NPI Multi-Specialty Clinic/Center · Grant, NE
NPI 1295089076 · NPPES record last updated Jan 13, 2022
Key facts
- NPI
- 1295089076
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- BANNER HEALTH PHYSICIANS WEST LLC
- Practice address
- 900 Lincoln Ave
Grant, NE 69140-3095 - Phone
- (308) 352-7200
- Fax
- (608) 352-7299
- NPI assigned
- Nov 1, 2012
- Organization subpart
- Yes
- Parent organization (as reported)
- BANNER MEDICAL GROUP COLORADO
Authorized official
- Name
- Dennis Laraway
- Title
- Cfo
- Phone
- (602) 747-4000
Corporate family (same tax ID) 17
National Provider Directory
- Tax ID family
- Banner Health Physicians West LLC
- Part of
- Tiffany Weathers
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
900 Lincoln Ave
Grant, NE 69140-3095
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Other providers in Grant, NE
- Shane B Banks
- Banner Health Physicians Colorado LLC
- John Matthew Byrd
- Colglazier Clinic
- Clifford Ray Colglazier
- Carol S. Cornelius
- County of Perkins
All providers in Grant, NE · Multi-Specialty Clinic/Center in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.