| Banner Health | |
|
3457 W White Mountain Blvd Lakeside AZ 85929-6007 | |
| (928) 358-1515 | |
| Not Available |
| Full Name | Banner Health |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 3457 W White Mountain Blvd, Lakeside, Arizona |
| Authorized Official Name and Position | Hoyt Skabelund (CEO) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Health 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: (602) 747-4000 | Banner Health 3457 W White Mountain Blvd Lakeside AZ 85929-6007 Ph: (928) 358-1515 |
| NPI Number | 1275320327 |
|---|---|
| Provider Enumeration Date | 04/22/2025 |
| Last Update Date | 04/22/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275320327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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