BANNER PEORIA SURGERY CENTER LLC NPI 1104341353

NPI Information

NPI: 1104341353
Provider Name: BANNER PEORIA SURGERY CENTER LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 03D2136728

Address:
13640 N PLAZA DEL RIO BLVD STE 135
PEORIA, AZ
ZIP 85381
Phone: (623) 234-4766
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BANNER PEORIA SURGERY CENTER LLC is an ambulatory surgical clinic center in Peoria, AZ. BANNER PEORIA SURGERY CENTER LLC NPI is 1104341353. The provider is registered as an organization entity type.

The provider's business location address is:

13640 N PLAZA DEL RIO BLVD STE 135
PEORIA, AZ
ZIP 85381-846
Phone: (623) 234-4766
Fax: (602) 801-3657

The provider's authorized official is Matthew Cox .
The authorized official title is Sr Vp Finance and has the following contact phone number (602) 747-4000.

The CLIA number assigned to this NPI record is 03D2136728 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/9/2017 and was last updated on 7/26/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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