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NPI Code Detail

MEDICARE: BANNER-UNIVERSITY MEDICAL GROUP

MEDICARE: BANNER-UNIVERSITY MEDICAL GROUP
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
1261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1568818649
Entity Type Code : Organization
Provider Name (Legal Business Name) : BANNER-UNIVERSITY MEDICAL GROUP
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 : 535 N WILMOT RD 2ND FL
Second Line :
City : TUCSON
State : AZ
Zip : 85711-2629
Country : US
Telephone Number : 520-694-1234
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : BENJAMIN SCHWARTZ
Credential :
Telephone Number : 602-747-4000
Provider Enumeration Date : 05/09/2016
Last Update Date : 11/24/2025

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Directions to “BANNER-UNIVERSITY MEDICAL GROUP ” Practice Location

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