| Organization Name: | BANNER HEALTH PHYSICIANS COLORADO LLC |
| NPI Number: | 1114204542 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DENNIS E DAHLEN (SR VP FINANCE) |
| Mailing Address: | 2400 Edison St Brush |
| State: | CO US |
| Postal Code: | 807231640 |
| Phone Number: | 9708426262 |
| Fax Number: | |
| NPI Enumeration Date: | 11/14/2011 |
| NPI Last Update Date: | 02/29/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |