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General NPI Number Information
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NPI Number | 1831637628
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Entity Type | Organization
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Legal Business Name | ROYAL TRANSPORTATION PROFESSIONAL LLC
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Dates
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Enumeration Date | 02/01/2017
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Last Update Date | 02/01/2017
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Provider Practice Location Address
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Address Line | 12014 N 79TH LN
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City | PEORIA
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State | AZ
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Zip | 85345-1323
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Country | US
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Telephone | 623-419-3327
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Fax |
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Provider Business Mailing Address
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Address Line | 7558 W THUNDERBIRD RD 1-424
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City | PEORIA
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State | AZ
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Zip | 85381-6080
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Country | US
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Telephone | 623-419-3327
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MR. ROYAL BENNETT
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Credential |
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Telephone | 623-707-5598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 21036376-B
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License Number State | AZ
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