| Banner Health Physicians Colorado Llc | |
|
608 E Harmony Rd Ste 101 Fort Collins CO 80525-3210 | |
| (970) 821-4702 | |
| (970) 744-5305 |
| Full Name | Banner Health Physicians Colorado Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 608 E Harmony Rd Ste 101, Fort Collins, Colorado |
| Authorized Official Name and Position | Dennis L Laraway (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Health Physicians Colorado Llc 2901 N Central Ave Phoenix AZ 85012-2700 Ph: () - | Banner Health Physicians Colorado Llc 608 E Harmony Rd Ste 101 Fort Collins CO 80525-3210 Ph: (970) 821-4702 |
| NPI Number | 1053080614 |
|---|---|
| Provider Enumeration Date | 09/08/2021 |
| Last Update Date | 09/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053080614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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