MEDICARE: ROYAL MEDICAL SUPPLIES

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	0075595	TX

General Provider Information

NPI Number	:	1427144682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL MEDICAL SUPPLIES

Provider Business Mailing Address
First Line	:	110 W RANDOL MILL RD STE 209
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-4611
Country	:	US
Telephone Number	:	817-548-0550
Fax Number	:	817-548-0540

Provider Business Practice Location Address
First Line	:	110 W RANDOL MILL RD STE 209
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-4611
Country	:	US
Telephone Number	:	817-548-0550
Fax Number	:	817-548-0540

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ADEWALE AKANNI SHODEKE
Credential	:
Telephone Number	:	817-548-0550

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	08/18/2008

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Directions to “ROYAL MEDICAL SUPPLIES ” Practice Location

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