Organization · NPI-2

Banner Health Physicians Colorado LLC

Clinic/Center · Longmont, CO

NPI number1710801170
StatusActive
Last updated in NPPESAug 7, 2026

Details

NPI
1710801170
Entity type
Organization (NPI-2)
Legal business name
Banner Health Physicians Colorado LLC
Organization subpart
Yes
Enumeration date
Aug 7, 2026
Certification date
Aug 7, 2026
Last updated
Aug 7, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

205 S Main St Ste B
Longmont, CO 80501-1714

Phone 303-722-6244

Mailing address

2901 N Central Ave Ste 160
Phoenix, AZ 85012-2702

Phone 602-747-4000

Authorized official

Paris Labruzzo
Sr Director
6027474000

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