1417190893 NPI number — ROYAL CARE HEALTH SERVICES LLC

Table of content: (NPI 1417190893)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417190893 NPI number — ROYAL CARE HEALTH SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROYAL CARE HEALTH SERVICES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1417190893
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2006 TWIN FLOWER CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GROVE CITY
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43123-8024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-260-7834
Provider Business Mailing Address Fax Number:
614-875-7474

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
113 N OHIO AVE
Provider Second Line Business Practice Location Address:
SUITE 311
Provider Business Practice Location Address City Name:
SIDNEY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45365-2786
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-752-2808
Provider Business Practice Location Address Fax Number:
614-875-7474
Provider Enumeration Date:
04/14/2009

Additional Information

Authorized Official

Authorized Official Last Name:
ALAGBE
Authorized Official First Name:
ROSY
Authorized Official Middle Name:
U
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
614-260-7834

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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