=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699209593
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROYAL HEALTH TRANSPORTATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2017
-----------------------------------------------------
Last Update Date | 04/20/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2249 N MAIN ST
-----------------------------------------------------
City | TARBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27886-2106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-907-2737
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2249 N MAIN ST
-----------------------------------------------------
City | TARBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27886-2106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-907-2737
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MARY HYMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 252-548-0578
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 347B00000X
-----------------------------------------------------
Taxonomy Name | Bus
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------