MEDICARE: ROYAL TRANSPORTATION SERVICE

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)		TN

General Provider Information

NPI Number	:	1831368729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL TRANSPORTATION SERVICE

Provider Business Mailing Address
First Line	:	PO BOX 901079
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38190-1079
Country	:	US
Telephone Number	:	901-346-6969
Fax Number	:

Provider Business Practice Location Address
First Line	:	2390 LAMAR AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38114-3711
Country	:	US
Telephone Number	:	901-346-6969
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	IRA HENDERSON MURPHY
Credential	:
Telephone Number	:	901-346-6969

Provider Enumeration Date	:	02/25/2008
Last Update Date	:	02/25/2008

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