OrganizationActive
Banner Health
NPI 1396156139 · Non-Pharmacy Dispensing Site · Peoria, AZ
Provider details
- NPI number
- 1396156139
- Entity type
- Organization
- Primary specialty
- Non-Pharmacy Dispensing SiteSuppliers
- Parent organization
- Medvantx, Inc.
- Organization subpart
- Yes
- Authorized official
- Dennis Laraway, Cfo(602) 747-4000
- License
- 16098 (AZ)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
13640 N Plaza Del Rio Blvd
3rd Floor, Suite 350
Peoria, AZ 85381-4846
Phone: (623) 583-5044
Street-level locationGet directions
Mailing address
2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702
Other names (DBA / former)
- Doing business as
- Banner Health Center Peoria
- Doing business as
- Banner Health Center Peoria
Registry dates
- Enumerated
- 2014-05-14
- Last updated
- 2022-01-31
- Certified
- 2022-01-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.