Banner Good Samaritan Bariatric Program

LBN: Banner Good Samaritan Bariatric Program
Banner Good Samaritan Bariatric Program is an health care organization with primary practice located at 1300 N 12Th St , Phoenix AZ 85006-2850. The organization recently has only one registered license in Ambulatory Health Care Facilities / Clinic/Center, which is considered as the primary health care specialty. Banner Good Samaritan Bariatric Program can be contacted via phone (602) 239-5000, or through Dahlen, Dennis via phone (602) 495-4000.

Contact Information

Primary practice address
1300 N 12Th St Phoenix AZ 85006-2850
Phone: (602) 239-5000
Fax: (602) 239-3339
Website:
Map and Directions
Authorized official contact:
Name: Dahlen, Dennis
Phone: (602) 495-4000

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Clinic/Center 261Q00000X

Profile Details

NPI number 1134172679
LBN Legal business name Banner Good Samaritan Bariatric Program
DBA Doing business as
Authorized official Dahlen, Dennis
Entity Organization
Organization subpart 1 Yes
Enumeration date May 18th, 2006
Last updated Oct 15th, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134172679 NPPES
Arizona MEDICAID 810871

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