| NPI | 1609245588 |
|---|---|
| Doing Business As | BANNER FAMILY PHARMACY - GATEWAY |
| Entity Type | Organization |
| Authorized Contact | DENNIS LARAWAY CFO 602-747-4000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2021-12-17 |