NPIMap

Organization Active NPI

Banner Health

  • Clinic Pharmacy
  • Phoenix, AZ
National Provider Identifier
1497848824
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
3146 Issued in AZ
Legal business name
BANNER HEALTH
Practice address
925 E McDowell Rd
Phoenix, AZ 85006-2502
Phone
(602) 239-4792
Fax
(602) 239-6790
NPI assigned
Sep 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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

Authorized official

Name
Dennis Laraway
Title
Cfo
Phone
(602) 747-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 3146 AZ Primary

Addresses

Primary practice location

925 E McDowell Rd
Phoenix, AZ 85006-2502

Mailing address

2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702

Other identifiers 1

IdentifierTypeStateIssuer
0354441OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • BANNER GOOD SAMARITAN OP CLINIC PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
M E Lee MD28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1497848824",
    "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": "925 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062502",
            "telephone_number": "602-239-4792",
            "fax_number": "602-239-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-30",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "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"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "AZ",
            "license": "3146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "0354441",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BANNER GOOD SAMARITAN OP CLINIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BANNER GOOD SAMARITAN OP CLINIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2022; 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.