MEDICARE: ANA DRAGIC

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	310400000X	Assisted Living Facility	AL12025H	AZ

General Provider Information

NPI Number	:	1831853241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANA DRAGIC

Provider Business Mailing Address
First Line	:	3843 W BERYL AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-1137
Country	:	US
Telephone Number	:	602-919-1851
Fax Number	:	480-522-1975

Provider Business Practice Location Address
First Line	:	3843 W BERYL AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85051-1137
Country	:	US
Telephone Number	:	602-919-1851
Fax Number	:	480-522-1975

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2021
Last Update Date	:	10/22/2021

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Directions to “ ANA DRAGIC ” Practice Location

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