Healthcare Provider Details

I. General information

NPI: 1851842892
Provider Name (Legal Business Name): BANNER HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 16TH ST
GREELEY CO
80631-5154
US

IV. Provider business mailing address

1801 16TH ST
GREELEY CO
80631-5154
US

V. Phone/Fax

Practice location:
  • Phone: 970-820-6165
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: JANUARY WINDELL
Title or Position: WELLNESS SR. MANAGER
Credential:
Phone: 970-820-6165