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NPI Code Detail

MEDICARE: BANNER ALZHEIMER'S INSTITUTE

MEDICARE: BANNER ALZHEIMER'S INSTITUTE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0600XClinical Neurophysiology Physician
22084P0800XPsychiatry Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013966712
Entity Type Code : Organization
Provider Name (Legal Business Name) : BANNER ALZHEIMER'S INSTITUTE
Provider Business Mailing Address
First Line : 2901 N CENTRAL AVE STE 160
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2702
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2901 N CENTRAL AVE STE 106
Second Line :
City : PHOENIX
State : AZ
Zip : 85012-2700
Country : US
Telephone Number : 602-747-4000
Fax Number :
Authorized Official
Title or Position : CEO/CSO
Name : ERIC REIMAN
Credential :
Telephone Number : 602-747-4000
Provider Enumeration Date : 05/09/2006
Last Update Date : 09/02/2025

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Directions to “BANNER ALZHEIMER'S INSTITUTE ” Practice Location

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