Banner Health Physicians Colorado LLC
Clinic/Center, Multi-Specialty in Loveland, CO. Organization (NPI-2).
NPI number1134483472
StatusActive
Last updated in NPPESFeb 11, 2022
Details
- NPI
- 1134483472
- Entity type
- Organization (NPI-2)
- Legal business name
- Banner Health Physicians Colorado LLC
- Organization subpart
- Yes
- Enumeration date
- Jul 2, 2012
- Certification date
- Feb 11, 2022
- Last updated
- Feb 11, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | Yes |
Practice location
2555 E 13th St Ste 100Loveland, CO 80537-5134
Phone 970-613-1745 · Fax 970-461-6160
Mailing address
2901 N Central Ave Ste 160Phoenix, AZ 85012-2702
Authorized official
Dennis Laraway
Cfo
6027474000
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