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General NPI Number Information
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NPI Number | 1386674240
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Entity Type | Organization
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Legal Business Name | BANNER ARIZONA MEDICAL CLINIC, LTD
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 09/11/2009
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Provider Practice Location Address
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Address Line | 14418 W MEEKER BLVD STE 105
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-5283
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Country | US
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Telephone | 623-583-5240
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Fax | 623-583-5235
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Provider Business Mailing Address
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Address Line | 14418 W MEEKER BLVD STE 105
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-5283
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Country | US
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Telephone | 623-583-5240
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Fax | 623-583-5235
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MARGARET A BURKE
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Credential |
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Telephone | 623-876-3967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | 7-548
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License Number State | AZ
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