BANNER HEALTH CENTER AT PAYSON NPI 1316982648

NPI Information

  • NPI: 1316982648
  • Provider Name: BANNER HEALTH CENTER AT PAYSON
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 03D2271876
  • Address: 117 EAST MAIN STREET
    PAYSON, AZ
    ZIP 85541
  • Phone: (928) 474-1714

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NPI Details

BANNER HEALTH CENTER AT PAYSON is a primary care clinic center in Payson, AZ. BANNER HEALTH CENTER AT PAYSON NPI is 1316982648. The provider is registered as an organization entity type.

The provider's business location address is:

117 EAST MAIN STREET
PAYSON, AZ
ZIP 85541-662
Phone: (928) 474-1714

The provider's authorized official is Dennis Dahlen .
The authorized official title is Sr Vice President Finance and has the following contact phone number (602) 747-4000.

The CLIA number assigned to this NPI record is 03D2271876 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/19/2006 and was last updated on 7/31/2008.

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
1261QP2300XClinic/CenterPrimary CareYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1538689MEDICAIDARIZONA
2Z74000MEDICARE PINARIZONA

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: 3/30/2025

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