Healthcare Provider Details

I. General information

NPI: 1750144804
Provider Name (Legal Business Name): IAMROYAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2024
Last Update Date: 03/26/2024
Certification Date: 03/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S CHARLOTTE AVE UNIT 292
MONROE NC
28112-7166
US

IV. Provider business mailing address

101 S CHARLOTTE AVE UNIT 292
MONROE NC
28112-5526
US

V. Phone/Fax

Practice location:
  • Phone: 980-439-9533
  • Fax:
Mailing address:
  • Phone: 980-439-9533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: WALTER DAVIS KENDRICK
Title or Position: OWNER
Credential:
Phone: 980-439-9533