MEDICARE: ARIZONA IV DRIPS, 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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1972452563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA IV DRIPS, LLC

Provider Business Mailing Address
First Line	:	21755 N 77TH AVE STE 16
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85382-2111
Country	:	US
Telephone Number	:	623-329-5199
Fax Number	:	602-288-0505

Provider Business Practice Location Address
First Line	:	21755 N 77TH AVE STE 16
Second Line	:
City	:	PEORIA
State	:	AZ
Zip	:	85382-2111
Country	:	US
Telephone Number	:	623-329-5199
Fax Number	:	602-288-0505

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	JANA KING
Credential	:	FNP-C
Telephone Number	:	623-329-5199

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	01/26/2026

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Directions to “ARIZONA IV DRIPS, LLC ” Practice Location

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