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General NPI Number Information
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NPI Number | 1699884858
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Entity Type | Organization
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Legal Business Name | BANNER GATEWAY MEDICAL CENTER
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 1900 N HIGLEY RD
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City | GILBERT
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State | AZ
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Zip | 85234-1604
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Country | US
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Telephone | 480-543-2000
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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 | CEO
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Name | DARREN MCCOLLEM
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Credential |
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Telephone | 602-839-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QX0203X
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Taxonomy Name | Radiation Oncology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | PENDING
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License Number State |
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