| Organization Name: | BANNER HEALTH PHYSICIANS COLORADO LLC |
| NPI Number: | 1710316237 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DENNIS DAHLEN (SR. VP FINANCE) |
| Mailing Address: | 900 Lincoln Ave Grant |
| State: | NE US |
| Postal Code: | 691403095 |
| Phone Number: | 3083527200 |
| Fax Number: | 3083527299 |
| NPI Enumeration Date: | 11/05/2013 |
| NPI Last Update Date: | 11/05/2013 |
| 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: | |