BANNER URGENT CARE ARIZONA LLC NPI 1710508817

NPI Information

NPI: 1710508817
Provider Name: BANNER URGENT CARE ARIZONA LLC
Classification: Clinic/Center - 261QU0200X
Entity Type: Organization

Specialization: Urgent Care

CLIA Number: 03D2146756

Address:
3457 W WHITE MOUNTAIN BLVD
LAKESIDE, AZ
ZIP 85929
Phone: (928) 358-1515
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BANNER URGENT CARE ARIZONA LLC is an urgent care clinic center in Lakeside, AZ. BANNER URGENT CARE ARIZONA LLC NPI is 1710508817. The provider is registered as an organization entity type.

The provider's business location address is:

3457 W WHITE MOUNTAIN BLVD
LAKESIDE, AZ
ZIP 85929-007
Phone: (928) 358-1515

The provider's authorized official is Dennis Laraway .
The authorized official title is Chief Financial Officer and has the following contact phone number (602) 747-4000.

The CLIA number assigned to this NPI record is 03D2146756 - other - urgent care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/29/2020 and was last updated on 1/26/2022.

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	261QU0200X	Clinic/Center	Urgent Care			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: 4/28/2024

NPI Synchronization or Removal

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