| NPI | 1083035117 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2013-12-16 |
| Last Updated | 2026-04-15 |
| Authorized Official | Russell Funk CEO Phone: 6027474000 |
| Mailing Address | 2901 N Central Ave Ste 160 Phoenix, AZ 85012-2702 United States Phone: (602) 747-4000 📍 View Map |
| Primary Practice Address | 1400 S Dobson Rd Mesa, AZ 85202-4707 United States Phone: (480) 412-4250 | Fax: (480) 412-4252 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | — | 2145016 | PK |
| MEDICAID | AZ | 896515 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 333600000X – Pharmacy | — | — |
| Yes | 3336C0003X – Pharmacy, Community/Retail Pharmacy | AZ | Y005805 |
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About NPI 1083035117
Banner Pharmacy Services Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1083035117. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Mesa, AZ. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2013-12-16. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1083035117?
NPI 1083035117 belongs to Banner Pharmacy Services Llc, a Pharmacy, Community/Retail Pharmacy in Mesa, AZ. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1083035117 active?
The current status of NPI 1083035117 in the NPPES registry is Active. The record was last updated on 2026-04-15.
What specialty is NPI 1083035117?
NPI 1083035117 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1083035117?
You can verify NPI 1083035117 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1083035117?
The primary practice address on file for NPI 1083035117 is 1400 S Dobson Rd, Mesa, AZ 85202-4707. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1083035117 issued?
NPI 1083035117 was first issued (enumerated) on 2013-12-16. The NPPES record was last updated on 2026-04-15.
Practice Location Map
Banner Pharmacy Services Llc is located at 1400 S Dobson Rd, Mesa, AZ. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Banner Pharmacy Services Llc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1083035117. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | Y005805 | AZ |