DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: BANNER PHARMACY SERVICES LLC

MEDICARE: BANNER PHARMACY SERVICES LLC
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
1333600000XPharmacy
23336C0003XCommunity/Retail PharmacyY005804AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22145017OTHERPK

General Provider Information

NPI Number : 1205257334
Entity Type Code : Organization
Provider Name (Legal Business Name) : BANNER PHARMACY SERVICES LLC
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 : 602-747-4000
Fax Number :
Provider Business Practice Location Address
First Line : 5555 W THUNDERBIRD RD
Second Line :
City : GLENDALE
State : AZ
Zip : 85306-4622
Country : US
Telephone Number : 602-865-2378
Fax Number : 602-865-2373
Authorized Official
Title or Position : CEO
Name : RUSSELL FUNK
Credential :
Telephone Number : 602-747-4000
Provider Enumeration Date : 12/16/2013
Last Update Date : 04/15/2026

Similar Medicare Providers

1154355188 — BANNER THUNDERBIRD MEDICAL CENTER
Practice Location Address:
5555 W THUNDERBIRD RD
GLENDALE, AZ
85306-4622
Practice Phone: 602-865-5555
Practice Fax:
1699829929 — BANNER THUNDERBIRD MEDICAL CENTER
Practice Location Address:
5555 W THUNDERBIRD RD
GLENDALE, AZ
85306-4622
Practice Phone: 602-865-5555
Practice Fax: 602-865-5930
1497753123 — TONY W LEE DO
Practice Location Address:
5555 W THUNDERBIRD RD
GLENDALE, AZ
85306-4622
Practice Phone: 602-865-5555
Practice Fax:
1841280526 — MISS LAUREN MARY JOHNSON ATC, LAT, ARRT (MRI)
Practice Location Address:
5555 W THUNDERBIRD RD
GLENDALE, AZ
85306-4622
Practice Phone: 602-865-5594
Practice Fax:
1427049295 — MR. GEORGE PATRICK CANTINI PA
Practice Location Address:
5555 W THUNDERBIRD RD
GLENDALE, AZ
85306-4622
Practice Phone: 602-865-5501
Practice Fax:
1699748749 — ELIZABETH ARIANA RICCA CRNFA
Practice Location Address:
5555 W THUNDERBIRD RD
GLENDALE, AZ
85306-4622
Practice Phone: 623-910-4515
Practice Fax:

Directions to “BANNER PHARMACY SERVICES LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.