| Banner Health Physicians West Llc | |
|
200 South A Street Hawthorne NV 89415 | |
| (775) 423-3151 | |
| (775) 428-2166 |
| Full Name | Banner Health Physicians West Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 200 South A Street, Hawthorne, Nevada |
| 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 |
|---|---|
| Banner Health Physicians West Llc 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | Banner Health Physicians West Llc 200 South A Street Hawthorne NV 89415 Ph: (775) 423-3151 |
| NPI Number | 1154768042 |
|---|---|
| Provider Enumeration Date | 05/31/2013 |
| Last Update Date | 01/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154768042 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Mt Grant General Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 South A Street, Hawthorne, NV 89415 Phone: 775-945-2461 Fax: 775-945-2359 | |
Mt. Grant General Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1st And A St, Hawthorne, NV 89415 Phone: 775-945-2461 Fax: 775-945-2359 |