Healthcare Provider Details

I. General information

NPI: 1326024936
Provider Name (Legal Business Name): ROYAL TREATMENT URGENT MEDICAL CARE CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2005
Last Update Date: 07/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 OHIO RIVER BLVD # 602
SEWICKLEY PA
15143-2048
US

IV. Provider business mailing address

4017 WASHINGTON RD # 2000
MC MURRAY PA
15317-2520
US

V. Phone/Fax

Practice location:
  • Phone: 419-819-0488
  • Fax: 412-202-5375
Mailing address:
  • Phone: 412-202-5375
  • Fax: 412-202-5375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number4301073222
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number35079907R
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD434643
License Number StatePA

VIII. Authorized Official

Name: DR. STACEY Y ROYAL
Title or Position: OWNER
Credential:
Phone: 419-819-0488