Healthcare Provider Details

I. General information

NPI: 1801221247
Provider Name (Legal Business Name): DIANE M BANET PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2013
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16380 W YUMA RD
GOODYEAR AZ
85338-3100
US

IV. Provider business mailing address

16380 W YUMA RD
GOODYEAR AZ
85338-3100
US

V. Phone/Fax

Practice location:
  • Phone: 623-925-4442
  • Fax: 623-925-4443
Mailing address:
  • Phone: 623-925-4442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19896
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS021845
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: