MEDICARE: DRASEY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	2012 23640	CA

General Provider Information

NPI Number	:	1063771061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRASEY LLC

Provider Business Mailing Address
First Line	:	3435 E THOUSAND OAKS BLVD
Second Line	:	SUITE 7753
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91359-7901
Country	:	US
Telephone Number	:	805-657-7374
Fax Number	:

Provider Business Practice Location Address
First Line	:	1387 KATHLEEN DR
Second Line	:
City	:	NEWBURY PARK
State	:	CA
Zip	:	91320-4666
Country	:	US
Telephone Number	:	805-657-7374
Fax Number	:

Authorized Official
Title or Position	:	SOLE OWNER
Name	:	MS. RENEE WILKINS
Credential	:
Telephone Number	:	805-657-7374

Provider Enumeration Date	:	05/10/2012
Last Update Date	:	03/13/2017

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Directions to “DRASEY LLC ” Practice Location

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