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Banner Health — NPI 1588098313, Phoenix, AZ | NPI Central

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NPI 1588098313

OrganizationActive

Banner Health

NPI 1588098313 · Non-Pharmacy Dispensing Site · Phoenix, AZ

Provider details

NPI number: 1588098313
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Parent organization: Medvantx, Inc.
Authorized official: Dennis Laraway, Cfo
License: 19036 (AZ)

Practice location

1300 N 12th St

Suite 520

Phoenix, AZ 85006-2848

Phone: (602) 839-4456

More AZ providers

Mailing address

2901 N Central Ave Ste 160

Phoenix, AZ 85012-2702

Registry dates

Enumerated: 2013-08-28
Last updated: 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.