1093058935 NPI number — ROYAL HOMESTAR LLC

Table of content: (NPI 1093058935)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093058935 NPI number — ROYAL HOMESTAR LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROYAL HOMESTAR 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:
HOMESTAR MEDICAL EQUIPMENT
Provider Other Organization Name Type Code:
3
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:
1093058935
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
122 MILL RD
Provider Second Line Business Mailing Address:
SUITE A130
Provider Business Mailing Address City Name:
PHOENIXVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19460-1409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-630-6357
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
77 S COMMERCE WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18017-8917
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-526-7600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/28/2013

Additional Information

Authorized Official

Authorized Official Last Name:
DOUGLAS WILSON
Authorized Official First Name:
MICHELE
Authorized Official Middle Name:
J
Authorized Official Title or Position:
SECRETARY TREASURER/CFO
Authorized Official Telephone Number:
610-420-5657

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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