NPI | 1487023412 |
---|---|
Doing Business As | BANNER FAMILY PHARMACY - GATEWAY |
Entity Type | Organization |
Authorized Contact | DENNIS LARAWAY CFO 602-747-4000 |
Organization Subpart ? | Yes |
Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2015-09-21 |
Last Update Date | 2021-12-17 |