Basic Information
| Provider Information | |||||||||
| NPI: | 1518959238 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PRAGIT | ||||||||
| FirstName: | JANET | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4600 S MILL AVE | ||||||||
| Address2: | 280 | ||||||||
| City: | TEMPE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852826757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4803052888 | ||||||||
| FaxNumber: | 4803052889 | ||||||||
| Practice Location | |||||||||
| Address1: | 3100 N ALMA SCHOOL RD | ||||||||
| Address2: | |||||||||
| City: | CHANDLER | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852241468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806778282 | ||||||||
| FaxNumber: | 4806778283 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2005 | ||||||||
| LastUpdateDate: | 09/14/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 7209350001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332B00000X | 7045160001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332B00000X | 7046960001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332B00000X | 7034950001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332B00000X | 6748310001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332B00000X | 705360001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332B00000X | 7629170001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 332B00000X | 7047150001 | AZ | N | Suppliers | Durable Medical Equipment & Medical Supplies | 207Q00000X | 4719 | AZ | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 586215 | 05 | AZ | MEDICAID |