MEDICARE: ROYALTY'S ANCILLARY SERVICES

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1760915987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYALTY'S ANCILLARY SERVICES

Provider Business Mailing Address
First Line	:	702 NELSON DR
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-9216
Country	:	US
Telephone Number	:	469-661-7756
Fax Number	:

Provider Business Practice Location Address
First Line	:	702 NELSON DR
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-9216
Country	:	US
Telephone Number	:	469-661-7756
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	NAYSHALA SMITH
Credential	:
Telephone Number	:	469-661-7756

Provider Enumeration Date	:	04/05/2017
Last Update Date	:	04/05/2017

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