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General NPI Number Information
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NPI Number | 1467506857
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Entity Type | Organization
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Legal Business Name | BANNER -- UNIVERSITY MEDICAL CENTER PHOENIX
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 12/23/2021
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Provider Practice Location Address
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Address Line | 1012 E WILLETTA ST FL 3
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City | PHOENIX
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State | AZ
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Zip | 85006-2749
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Country | US
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Telephone | 602-239-2361
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Fax |
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Provider Business Mailing Address
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Address Line | 2901 N CENTRAL AVE STE 160
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City | PHOENIX
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State | AZ
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Zip | 85012-2702
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | DENNIS LARAWAY
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Credential |
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Telephone | 602-747-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number |
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License Number State |
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