Healthcare Provider Details
I. General information
NPI: 1487323234
Provider Name (Legal Business Name): ROYAL SPECIAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/07/2021
Last Update Date: 09/07/2021
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
214 KENT RD
UPPER DARBY PA
19082-4205
US
IV. Provider business mailing address
214 KENT RD
UPPER DARBY PA
19082-4205
US
V. Phone/Fax
- Phone: 610-352-2950
- Fax:
- Phone: 610-352-2950
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 372500000X |
| Taxonomy | Chore Provider |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TUBMAN
POPEH
Title or Position: OWNER
Credential:
Phone: 610-352-2950