MEDICARE: ROYAL R. RELIABLE TRANSPORTATION SERVICES LLC

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	342000000X	Transportation Network Company
2	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1508543893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL R. RELIABLE TRANSPORTATION SERVICES LLC

Provider Business Mailing Address
First Line	:	8191 CALABASH AVE SPC 39
Second Line	:
City	:	FONTANA
State	:	CA
Zip	:	92335-0298
Country	:	US
Telephone Number	:	310-254-6401
Fax Number	:

Provider Business Practice Location Address
First Line	:	8191 CALABASH AVE SPC 39
Second Line	:
City	:	FONTANA
State	:	CA
Zip	:	92335-0298
Country	:	US
Telephone Number	:	310-254-6401
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	BRANDON K RAYFORD
Credential	:
Telephone Number	:	310-254-6401

Provider Enumeration Date	:	06/29/2023
Last Update Date	:	07/04/2023

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