| NPI | 1639561624 |
|---|---|
| Doing Business As | BANNER FAMILY PHARMACY-GATEWAY |
| Entity Type | Organization |
| Authorized Contact | DENNIS LARAWAY CFO 602-747-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: AZ Y006339) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2021-12-17 |