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NPI Code Detail

MEDICARE: AIDA DRACK

MEDICARE: AIDA DRACK
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
13747P1801XPersonal Care AttendantNV

General Provider Information

NPI Number : 1225539661
Entity Type Code : Individual
Provider Name (Legal Business Name) : AIDA DRACK
Provider Business Mailing Address
First Line : 4141 COMPASS ROSE WAY
Second Line :
City : LAS VEGAS
State : NV
Zip : 89108-5483
Country : US
Telephone Number : 702-324-7255
Fax Number :
Provider Business Practice Location Address
First Line : 4350 ARVILLE ST STE 40
Second Line :
City : LAS VEGAS
State : NV
Zip : 89103-3811
Country : US
Telephone Number : 702-202-3184
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2018
Last Update Date : 06/16/2018

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Directions to “ AIDA DRACK ” Practice Location

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