MEDICARE: ROYALTY AMBULANCE SERVICES INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1164669420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYALTY AMBULANCE SERVICES INC.

Provider Business Mailing Address
First Line	:	3235 N SAN FERNANDO RD
Second Line	:	UNIT # 6
City	:	LOS ANGELES
State	:	CA
Zip	:	90065-1443
Country	:	US
Telephone Number	:	818-550-5833
Fax Number	:	818-550-1993

Provider Business Practice Location Address
First Line	:	3235 N SAN FERNANDO RD
Second Line	:	UNIT # 6
City	:	LOS ANGELES
State	:	CA
Zip	:	90065-1443
Country	:	US
Telephone Number	:	818-550-5833
Fax Number	:	818-550-1993

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SIMON AGOPIAN
Credential	:
Telephone Number	:	818-550-5833

Provider Enumeration Date	:	01/08/2009
Last Update Date	:	09/20/2010

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