Healthcare Provider Details

I. General information

NPI: 1093029142
Provider Name (Legal Business Name): ROYALS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2010
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20727 WYOMING ST
FERNDALE MI
48220-2141
US

IV. Provider business mailing address

20727 WYOMING ST
FERNDALE MI
48220-2141
US

V. Phone/Fax

Practice location:
  • Phone: 248-566-0116
  • Fax: 248-566-0117
Mailing address:
  • Phone: 248-566-0116
  • Fax: 248-566-0117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5315052030
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HIMAL SHAH
Title or Position: OWNER, PIC
Credential: RPH
Phone: 231-580-1601