NPIMap

Organization Active NPI

Banner Pharmacy Services LLC

Doing business as Banner Family Pharmacy-Univ. Med. Institute 1441

  • Community/Retail Pharmacy
  • Phoenix, AZ
National Provider Identifier
1902256092
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
Y006870 Issued in AZ
Legal business name
BANNER PHARMACY SERVICES LLC
Doing business as
Banner Family Pharmacy-Univ. Med. Institute 1441
Practice address
1441 N 12TH St
Phoenix, AZ 85006-2837
Phone
(602) 521-5000
Fax
(602) 521-5010
NPI assigned
Jun 20, 2016
Last updated
Apr 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Authorized official

Name
Russell Funk
Title
Ceo
Phone
(602) 747-4000

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X Y006870 AZ Primary
Specialty Pharmacy 3336S0011X NU

Addresses

Primary practice location

1441 N 12TH St
Phoenix, AZ 85006-2837

Mailing address

2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Phone (602) 747-4000

Other identifiers 2

IdentifierTypeStateIssuer
178558MedicaidAZ
2160984OtherPK

Other names 1

  • Banner Family Pharmacy-Univ. Med. Institute 1441 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140610000246 AZ Part B Supplier - Mass Immunization (Roster Biller Only) 9830322114 15 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Casa Grande, AZ; Tucson, AZ; Sun City West, AZ; Sun City, AZ; Phoenix, AZ; Mesa, AZ; Gilbert, AZ; Glendale, AZ
O20170329002170 AZ DME Supplier - Pharmacy 9830322114 Practice locations: Phoenix, AZ

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 15

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 15

National Provider Directory

National Provider Directory
Tax ID family
Banner Pharmacy Services LLC21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

  • Banner Health

    dba Banner Hospice of Northern Colorado

    • Community Based Hospice Care Agency
    • Greeley, CO
    • NPI 1407409964

    Member Of

    NPD member

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1902256092",
    "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",
            "telephone_number": "602-747-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-5000",
            "fax_number": "602-521-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER PHARMACY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "FUNK",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "602-747-4000"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y006870",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178558",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2160984",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banner Family Pharmacy-Univ. Med. Institute 1441",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Banner Family Pharmacy-Univ. Med. Institute 1441",
            "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 Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.