Banner Medical Group Greeley LLC

Organization Active NPI Multi-Specialty Clinic/Center · Johnstown, CO

NPI 1386817880 · NPPES record last updated Dec 16, 2008

Key facts

NPI
1386817880
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
Legal business name
BANNER MEDICAL GROUP GREELEY LLC
Practice address
222 Johnstown Center Dr
Johnstown, CO 80534-9030
Phone
(970) 587-4974
NPI assigned
Apr 7, 2008
Organization subpart
Yes
Parent organization (as reported)
BANNER HEALTH

Authorized official

Name
Dennis Dahlen
Title
Sr Vice President Finance
Phone
(602) 747-4000

Member of 1

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

Practitioners 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 45

National Provider Directory

Part of
M E Lee MD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Yes

Addresses

Primary practice location

222 Johnstown Center Dr
Johnstown, CO 80534-9030

Mailing address

1441 N 12TH St
Phoenix, AZ 85006-2837

Other identifiers

IdentifierTypeStateIssuer
05725046MedicaidCO

Other providers in Johnstown, CO

All providers in Johnstown, CO · Multi-Specialty Clinic/Center in Colorado

Sources for this page

Verify at the official NPI Registry.