Banner Family Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

Y005805 Issued in AZ

Legal business name

BANNER FAMILY PHARMACY

Doing business as

Banner Family Pharmacy Desert

Practice address

1400 S Dobson Rd
Mesa, AZ 85202-4707

Phone

(480) 412-4250

Fax

(480) 412-4252

NPI assigned

Oct 16, 2013

Organization subpart

No

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

Authorized official

Name

Evelin Robles

Title

Phcy Ops Senior Manager

Phone

(480) 412-4250

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Banner Family Pharmacy Desert Doing business as

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

{
    "created_epoch": "1381881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391126400000",
    "number": "1588092282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-839-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S DOBSON RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024707",
            "telephone_number": "480-412-4250",
            "fax_number": "480-412-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER FAMILY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-16",
        "last_updated": "2014-01-31",
        "status": "A",
        "authorized_official_last_name": "ROBLES",
        "authorized_official_first_name": "EVELIN",
        "authorized_official_title_or_position": "PHCY OPS SENIOR MANAGER",
        "authorized_official_telephone_number": "480-412-4250"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y005805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "863491",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142567",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banner Family Pharmacy Desert",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Banner Desert Medical Center
• Banner Desert Medical Center (Banner Desert Care Center)
• Banner Desert Medical Center
• Banner Desert Outpatient Pharmacy
• Banner Desert Surgery Center LP
• Banner Health Clinic
• Banner Health Dba Cardon Childrens Medical Center
• Banner Heart Hospital
• Banner Home Care-Arizona
• Banner Home Care-Arizona

• Community/Retail Pharmacy in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Community/Retail Pharmacy in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; 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.