Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Banner Health

Organization Non-Pharmacy Dispensing Site · NPI 1316358013

Banner Health is a Non-Pharmacy Dispensing Site in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2014.

Licensed in
AZ
In the registry since
2014

Practice location Address checks out

1300 N 12th St Ste 605
Phoenix, AZ 85006-2848
Phone: (602) 839-2668
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Non-Pharmacy Dispensing Site (primary) Taxonomy 332900000X · Licence 45424 (AZ)

Record details

NPI number1316358013
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationMedvantx, Inc
Authorized official Dennis Laraway — Cfo · (602) 747-4000
Other names Good Samaritan Medicine Residency 12th St; Good Samaritan Medicine Residency 12th St
NPI enumeratedMay 15, 2014
Last updated in NPPESJanuary 31, 2022
Certification dateJanuary 31, 2022
Mailing address2901 N Central Ave Ste 160, Phoenix, AZ 85012-2702

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