Banner Hospital Based Physicians Colorado Llc | |
400 S 15th St Worland WY 82401-3531 | |
(307) 347-6958 | |
Not Available |
Full Name | Banner Hospital Based Physicians Colorado Llc |
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Speciality | Clinic/center - Multi-specialty |
Location | 400 S 15th St, Worland, 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 |
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Banner Hospital Based Physicians Colorado Llc 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | Banner Hospital Based Physicians Colorado Llc 400 S 15th St Worland WY 82401-3531 Ph: (307) 347-6958 |
NPI Number | 1629316641 |
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Provider Enumeration Date | 01/25/2013 |
Last Update Date | 01/28/2022 |
Identifier | Type | State | Issuer |
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1629316641 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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