MEDICARE: SCOTT ROYSTER

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	172A00000X	Driver
2	374U00000X	Home Health Aide
3	376J00000X	Homemaker

General Provider Information

NPI Number	:	1689358921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT ROYSTER

Provider Business Mailing Address
First Line	:	5093 SHERMAN WOOD DR
Second Line	:
City	:	KENT
State	:	OH
Zip	:	44240-7046
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5093 SHERMAN WOOD DR
Second Line	:
City	:	KENT
State	:	OH
Zip	:	44240-7046
Country	:	US
Telephone Number	:	330-881-3254
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2023
Last Update Date	:	06/14/2023

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Directions to “ SCOTT ROYSTER ” Practice Location

Language	Start Address	Practice Location

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