MEDICARE: ROYAL AMERICAN CARE PROVIDERS 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1700242021
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL AMERICAN CARE PROVIDERS INC

Provider Business Mailing Address
First Line	:	PO BOX 19368
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89511-1678
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5470 KIETZKE LN
Second Line	:	SUITE 300
City	:	RENO
State	:	NV
Zip	:	89511-3023
Country	:	US
Telephone Number	:	775-530-9101
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT/TREASURER/ADMIN
Name	:	ADEFUNKE VANDENBURG
Credential	:
Telephone Number	:	775-530-9101

Provider Enumeration Date	:	01/04/2016
Last Update Date	:	01/04/2016

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