| Banner Health | |
|
6152 W Hardscrabble Mesa Rd Pine AZ 85544-5238 | |
| (928) 596-4848 | |
| Not Available |
| Full Name | Banner Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 6152 W Hardscrabble Mesa Rd, Pine, Arizona |
| Authorized Official Name and Position | Margo Karsten (DIVISION PRESIDENT) |
| Authorized Official Contact | 6027474000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Banner Health 2901 N Central Ave Ste 160 Phoenix AZ 85012-2702 Ph: () - | Banner Health 6152 W Hardscrabble Mesa Rd Pine AZ 85544-5238 Ph: (928) 596-4848 |
| NPI Number | 1245940287 |
|---|---|
| Provider Enumeration Date | 11/30/2022 |
| Last Update Date | 11/30/2022 |
| Medicare PECOS PAC ID | 9537078365 |
|---|---|
| Medicare Enrollment ID | O20230324001850 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245940287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Lisa Marie York, Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6152 Hardscrabble Road, Pine, AZ 85544 Phone: 928-476-3258 Fax: 928-476-3186 |