Banner Health Physicians West LLC
Organization Active NPI Multi-Specialty Clinic/Center · Powell, WY
NPI 1689301103 · NPPES record last updated Aug 4, 2022
Key facts
- NPI
- 1689301103
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- BANNER HEALTH PHYSICIANS WEST LLC
- Practice address
- 777 Avenue H
Powell, WY 82435-2260 - Phone
- (307) 347-5810
- Fax
- (307) 347-5808
- NPI assigned
- Aug 4, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- BANNER MEDICAL GROUP COLORADO
Authorized official
- Name
- Shiva Birdi
- Title
- Ceo BMG
- 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
777 Avenue H
Powell, WY 82435-2260
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Other providers in Powell, WY
- Thomas Glen Asay
- John E Asher
- Andrew B Baker
- Heather Bales
- Shay Bales
- Noah Phinneaus Alexander Barlow
- Matthew Ty Barrus
- Dean Wayne Bartholomew
- Kara Baus
- Mandi Jo Baxendale
All providers in Powell, 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 4, 2022. 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.