MEDICARE: STAY DRIPPED IV 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	163WI0500X	Infusion Therapy Registered Nurse

General Provider Information

NPI Number	:	1952198483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAY DRIPPED IV LLC

Provider Business Mailing Address
First Line	:	3007 N 73RD ST STE B
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7203
Country	:	US
Telephone Number	:	480-826-3353
Fax Number	:

Provider Business Practice Location Address
First Line	:	3007 N 73RD ST STE B
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85251-7203
Country	:	US
Telephone Number	:	480-826-3353
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. JABARI REEVES
Credential	:	MD
Telephone Number	:	510-333-4000

Provider Enumeration Date	:	04/21/2025
Last Update Date	:	04/21/2025

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Directions to “STAY DRIPPED IV LLC ” Practice Location

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