1831591338 NPI number — ROYAL HOME CARE, INC.

Table of content: (NPI 1831591338)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831591338 NPI number — ROYAL HOME CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROYAL HOME CARE, INC.
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:
1831591338
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 36409
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENSBORO
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27416-6409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-681-8497
Provider Business Mailing Address Fax Number:
844-852-7565

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3341 W NORTH AVE
Provider Second Line Business Practice Location Address:
SUITE 129
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53208-1457
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-681-8497
Provider Business Practice Location Address Fax Number:
844-852-7565
Provider Enumeration Date:
09/16/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PHETVISAY
Authorized Official First Name:
NYLA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
800-681-8497

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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