MEDICARE: ROYALTY PRODUCTIONS 419

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	174200000X	Meals Provider
2	343900000X	Non-emergency Medical Transport (VAN)
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1720961980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYALTY PRODUCTIONS 419

Provider Business Mailing Address
First Line	:	1320 YATES ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43608-2558
Country	:	US
Telephone Number	:	419-819-2726
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 YATES ST
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43608-2558
Country	:	US
Telephone Number	:	419-819-2726
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ANTUANETTE RUSSELL
Credential	:
Telephone Number	:	419-819-2726

Provider Enumeration Date	:	07/28/2025
Last Update Date	:	12/11/2025

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1134991565 — DEONAH RENEE GREEN
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1194923060 — DR. ATEEQ AHMED HASEEB M.D
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1184888208 — DR. JOHN JOSEPH LESKOVAN D.O.
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Directions to “ROYALTY PRODUCTIONS 419 ” Practice Location

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