| Banner - University Medical Center Phoenix | |
|
1111 E Mcdowell Rd Phoenix AZ 85006-2612 | |
| (602) 239-2000 | |
| Not Available |
| Full Name | Banner - University Medical Center Phoenix |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1111 E Mcdowell Rd, Phoenix, Arizona |
| Authorized Official Name and Position | Dennis Laraway (CFO) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner - University Medical Center Phoenix 1441 N 12th St Phoenix AZ 85006-2837 Ph: () - | Banner - University Medical Center Phoenix 1111 E Mcdowell Rd Phoenix AZ 85006-2612 Ph: (602) 239-2000 |
| NPI Number | 1629122171 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 12/23/2021 |
| Certification Date | 12/23/2021 |
| Medicare PECOS PAC ID | 7719896547 |
|---|---|
| Medicare Enrollment ID | O20100817001262 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629122171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | H0016 (Arizona) | Primary |
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