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Banner Arizona Medical Clinic Ltd
Prosthetic/Orthotic Supplier in Peoria, Arizona
NPI 1487785002

Banner Arizona Medical Clinic Ltd is a Prosthetic/Orthotic Supplier based in Peoria, AZ. Banner Arizona Medical Clinic Ltd practices in Peoria, AZ. The NPI Number for Banner Arizona Medical Clinic Ltd is 1487785002 and holds a License No. OTC3932 (Arizona).

The current practice location address for Banner Arizona Medical Clinic Ltd is 13760 N 93Rd Ave, Peoria, AZ and can be reached out via phone at 623-876-3952 and via fax at 623-876-3975.

Location: 13760 N 93Rd Ave, Peoria, AZ, 85381-4846
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1487785002
Provider Name
Banner Arizona Medical Clinic Ltd
Credential
Provider Entity Type
Organization
Address
13760 N 93Rd Ave, Peoria, AZ, 85381-4846
Phone Number
623-876-3952
Fax Number
623-876-3975
Provider Enumeration Date
03/07/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
516437 05 AZ
institution
Provider Business Practice Location Address Details
Address
13760 N 93Rd Ave
City
Peoria
State
Arizona
Zip
85381-4201
Phone Number
623-876-3952
Fax Number
623-876-3975
person
Provider Business Mailing Address Details
Address
13760 N 93Rd Ave
City
Peoria
State
Arizona
Zip
85381-4201
Phone Number
623-876-3952
Fax Number
623-876-3975
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Durable Medical Equipment & Medical Supplies
Speciality
-
Taxonomy
332B00000X
License No.
OTC3932 (Arizona)
Definition
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
OTC3932 (Arizona)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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