| Banner Health Physicians West Llc | |
|
4108 Laramie St Cheyenne WY 82001-1969 | |
| (970) 493-1292 | |
| (970) 493-1210 |
| Full Name | Banner Health Physicians West Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 4108 Laramie St, Cheyenne, Wyoming |
| Authorized Official Name and Position | Dennis Laraway (CFO) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Health Physicians West Llc 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | Banner Health Physicians West Llc 4108 Laramie St Cheyenne WY 82001-1969 Ph: (970) 493-1292 |
| NPI Number | 1376279976 |
|---|---|
| Provider Enumeration Date | 07/26/2022 |
| Last Update Date | 07/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376279976 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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