NPIMap

Organization Active NPI

Banner Health

Doing business as Banner Good Samaritan Medical Center

  • Institutional Pharmacy
  • Phoenix, AZ
National Provider Identifier
1598867996
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
Y03147 Issued in AZ
Legal business name
BANNER HEALTH
Doing business as
Banner Good Samaritan Medical Center
Practice address
1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone
(602) 239-4558
Fax
(602) 239-6734
NPI assigned
Sep 5, 2006
Last updated
Jan 31, 2022By the provider in NPPES
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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X NU
Institutional Pharmacy 3336I0012X Y03147 AZ Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

1111 E McDowell Rd
Phoenix, AZ 85006-2612

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1987996OtherPK

Other names 1

  • BANNER GOOD SAMARITAN MEDICAL CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Big Horn Family Med28 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": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643587200000",
    "number": "1598867996",
    "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": "1111 E MCDOWELL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-239-4558",
            "fax_number": "602-239-6734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "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": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "AZ",
            "license": "Y03147",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "1987996",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BANNER GOOD SAMARITAN MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BANNER GOOD SAMARITAN MEDICAL CENTER",
            "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.