BANNER MEDICAL GROUP GREELEY LLC; NPI #1386817880

Contact Information

BANNER MEDICAL GROUP GREELEY LLC

222 JOHNSTOWN CENTER DR
JOHNSTOWN, CO 80534-9030

Phone: 970-587-4974
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Multi-Specialty	261QM1300X	70	Clinic or Group Practice

Indicates primary specialty

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NPI Profile & details for BANNER MEDICAL GROUP GREELEY LLC

NPI Number 1386817880

LBN Legal business name BANNER MEDICAL GROUP GREELEY LLC

Authorized official DENNIS DAHLEN - (SR VICE PRESIDENT FINANCE)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 04/07/2008

Last updated 12/16/2008 - About 17 years ago

Identifiers

Medicaid

05725046

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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