Healthcare Provider Details
I. General information
NPI: 1750853388
Provider Name (Legal Business Name): BANNER URGENT CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/20/2018
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3247 E BELL RD STE 1
PHOENIX AZ
85032-2707
US
IV. Provider business mailing address
2901 N CENTRAL AVE STE 160
PHOENIX AZ
85012-2702
US
V. Phone/Fax
- Phone: 602-255-7655
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIAN
STANDAGE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 602-747-4000