National Provider Identifier Database

BANNER MEDICAL GROUP GREELEY LLC
Multi-Specialty


Contact Information

BANNER MEDICAL GROUP GREELEY LLC
222 JOHNSTOWN CENTER DR
JOHNSTOWN, CO80534-9030
Phone: 970-587-4974
Fax:
Website:
Specialty Taxonomy Code
* Multi-Specialty 261QM1300X

* Indicates primary specialty

NPI Profile & details for BANNER MEDICAL GROUP GREELEY LLC

NPI Number 1386817880
Legal business name
LBN
BANNER MEDICAL GROUP GREELEY LLC
Authorized official DENNIS DAHLEN - (SR VICE PRESIDENT FINANCE)
Entity Organization
Organization subpart Yes
Enumeration date 04/07/2008
Last updated 12/16/2008 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • CO Medicaid: 05725046

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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