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Banner Health Physicians Colorado LLC

Organization Active NPI Multi-Specialty Clinic/Center · Grant, NE

NPI 1710316237 · NPPES record last updated Mar 3, 2022

Key facts

NPI
1710316237
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
Legal business name
BANNER HEALTH PHYSICIANS COLORADO LLC
Practice address
900 Lincoln Ave
Grant, NE 69140-3095
Phone
(308) 352-7200
Fax
(308) 352-7299
NPI assigned
Nov 5, 2013
Organization subpart
Yes
Parent organization (as reported)
BANNER MEDICAL GROUP

Authorized official

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

Corporate family (same tax ID) 45

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

View all 45

National Provider Directory

Tax ID family
Banner Health Physicians (46 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Yes

Addresses

Primary practice location

900 Lincoln Ave
Grant, NE 69140-3095

Mailing address

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

Other providers in Grant, NE

All providers in Grant, NE · Multi-Specialty Clinic/Center in Nebraska

Sources for this page

Verify at the official NPI Registry.