MEDICARE: ROYAL NON MEDICAL TRANSPORT LLC

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1538815683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL NON MEDICAL TRANSPORT LLC

Provider Business Mailing Address
First Line	:	6683 N DELBERT AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-8305
Country	:	US
Telephone Number	:	559-960-4366
Fax Number	:

Provider Business Practice Location Address
First Line	:	6683 N DELBERT AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-8305
Country	:	US
Telephone Number	:	559-960-4366
Fax Number	:

Authorized Official
Title or Position	:	CHAIRMAN
Name	:	ALI M JIRDE
Credential	:
Telephone Number	:	559-960-4366

Provider Enumeration Date	:	02/28/2022
Last Update Date	:	02/28/2022

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