Healthcare Provider Details
I. General information
NPI: 1861318529
Provider Name (Legal Business Name): BANNER ESTRELLA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20751 W MARKET ST STE 100
BUCKEYE AZ
85396-7893
US
IV. Provider business mailing address
2901 N CENTRAL AVE STE 160
PHOENIX AZ
85012-2702
US
V. Phone/Fax
- Phone: 623-465-6595
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
COURTNEY
OPHAUG
Title or Position: CEO
Credential:
Phone: 602-747-4000