Banner Family Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

Y005712 Issued in AZ

Legal business name

BANNER FAMILY PHARMACY

Doing business as

Banner Family Pharmacy - Estrella

Practice address

9201 W Thomas Rd
Phoenix, AZ 85037-3332

Phone

(623) 327-6170

Fax

(623) 327-6171

NPI assigned

Sep 24, 2013

Organization subpart

No

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

Authorized official

Name

Deb Krmpotic, RPH

Title

Ceo

Phone

(623) 327-5001

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Banner Family Pharmacy - Estrella Doing business as

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

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386288000000",
    "number": "1972939882",
    "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": "623-327-6170",
            "fax_number": "623-327-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 W THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850373332",
            "telephone_number": "623-327-6170",
            "fax_number": "623-327-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANNER FAMILY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-12-06",
        "status": "A",
        "authorized_official_last_name": "KRMPOTIC",
        "authorized_official_first_name": "DEB",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "623-327-5001",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AZ",
            "license": "Y005712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "851577",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142167",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banner Family Pharmacy - Estrella",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Banner Estrella Surgery Center
• Banner Estrella Surgery Center
• Banner Estrella Surgery Center LLC
• Banner Executive Health LLC
• Banner Family Pharmacy
• Banner Good Samaritan
• Banner Good Samaritan Bariatric Program
• Banner Good Samaritan Medical Center
• Banner Good Samaritan Outpatient Clinic
• Banner Health

• Community/Retail Pharmacy in Phoenix, AZ
• Providers in Phoenix, 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 Dec 6, 2013; 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.