Provider Demographics
NPI:1063771061
Name:DRASEY LLC
Entity type:Organization
Organization Name:DRASEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-657-7374
Mailing Address - Street 1:3435 E THOUSAND OAKS BLVD
Mailing Address - Street 2:SUITE 7753
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91359-7901
Mailing Address - Country:US
Mailing Address - Phone:805-657-7374
Mailing Address - Fax:
Practice Address - Street 1:1387 KATHLEEN DR
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-4666
Practice Address - Country:US
Practice Address - Phone:805-657-7374
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-10
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2012 23640332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies