MEDICARE: RIFA ROYAL LENGTHS 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1780515981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIFA ROYAL LENGTHS LLC

Provider Business Mailing Address
First Line	:	329 VININGS WAY BLVD APT 9201
Second Line	:	BUILDING 9 APT 201
City	:	DESTIN
State	:	FL
Zip	:	32541-5368
Country	:	US
Telephone Number	:	850-460-5275
Fax Number	:

Provider Business Practice Location Address
First Line	:	329 VININGS WAY BLVD
Second Line	:
City	:	DESTIN
State	:	FL
Zip	:	32541-5367
Country	:	US
Telephone Number	:	850-460-5275
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGING MEMBER
Name	:	MS. SHERIFA O GALLOWAY
Credential	:
Telephone Number	:	850-460-5275

Provider Enumeration Date	:	05/27/2026
Last Update Date	:	05/27/2026

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