National Provider Identifier Database

BANNER MEDICAL GROUP GREELEY LLC
Multi-Specialty


Contact Information

BANNER MEDICAL GROUP GREELEY LLC
1300 MAIN ST
WINDSOR, CO80550-5989
Phone: 970-686-5646
Fax:
Website:
Specialty Taxonomy Code
* Multi-Specialty 261QM1300X

* Indicates primary specialty

NPI Profile & details for BANNER MEDICAL GROUP GREELEY LLC

NPI Number 1679804223
Legal business name
LBN
BANNER MEDICAL GROUP GREELEY LLC
Authorized official DENNIS DAHLEN - (SR VP FINANCE)
Entity Organization
Organization subpart Yes
Enumeration date 01/21/2010
Last updated 09/20/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • CO Medicaid: 14905086

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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