Banner Health Physicians West LLC
Organization Active NPI Multi-Specialty Clinic/Center · Riverton, WY
NPI 1528678786 · NPPES record last updated Aug 3, 2020
Key facts
- NPI
- 1528678786
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- BANNER HEALTH PHYSICIANS WEST LLC
- Practice address
- 2300 Gasser Rd
Riverton, WY 82501-2204 - Phone
- (307) 347-5810
- Fax
- (307) 347-5808
- NPI assigned
- Aug 3, 2020
- Organization subpart
- Yes
- Parent organization (as reported)
- BANNER MEDICAL GROUP COLORADO
Authorized official
- Name
- Dennis L Laraway
- Title
- Chief Legal Officer
- Phone
- (602) 747-4000
Corporate family (same tax ID) 17
National Provider Directory
- Tax ID family
- Banner Health Physicians West LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
2300 Gasser Rd
Riverton, WY 82501-2204
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Other providers in Riverton, WY
- Paul Alan Axthelm
- Tiffany L Bader
- Milsom June Baiely
- Michael Donald Baldwin
- Brian J Ballard
- Shanda Barlow
- Heather Barrows
- Wyatt Chester Barrus
- Grant A Basko
- Brandon Baxter
All providers in Riverton, WY · Multi-Specialty Clinic/Center in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2020. 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.