MEDICARE: ROYALTY MEDICAL SUPPLY CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1407952013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYALTY MEDICAL SUPPLY CORPORATION

Provider Business Mailing Address
First Line	:	14551 BEECHNUT ST APT 9307
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-4602
Country	:	US
Telephone Number	:	832-681-0285
Fax Number	:

Provider Business Practice Location Address
First Line	:	8633 W AIRPORT BLVD STE 1011
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-2479
Country	:	US
Telephone Number	:	713-776-0030
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EMMANUEL C EKONG
Credential	:
Telephone Number	:	832-681-0285

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	08/22/2020

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