Banner Medical Group Greeley Llc | |
5623 W 19th St Greeley CO 80634-2901 | |
(970) 353-9011 | |
Not Available |
Full Name | Banner Medical Group Greeley Llc |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 5623 W 19th St, Greeley, Colorado |
Authorized Official Name and Position | Dennis Dahlen (SR VP FINANCE) |
Authorized Official Contact | 6027474000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Banner Medical Group Greeley Llc 1441 N 12th St Phoenix AZ 85006-2837 Ph: () - | Banner Medical Group Greeley Llc 5623 W 19th St Greeley CO 80634-2901 Ph: (970) 353-9011 |
NPI Number | 1104070333 |
---|---|
Provider Enumeration Date | 11/14/2008 |
Last Update Date | 09/20/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104070333 | NPI | - | NPPES |
11658541 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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› Verified 4 days ago
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