MEDICARE: JULIA ROYAL HAND THAT CARE INC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1861072399
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULIA ROYAL HAND THAT CARE INC

Provider Business Mailing Address
First Line	:	4680 LIPSCOMB ST NE STE 6A
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-2928
Country	:	US
Telephone Number	:	321-208-5094
Fax Number	:	321-327-8227

Provider Business Practice Location Address
First Line	:	4680 LIPSCOMB ST NE STE 6A
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-2928
Country	:	US
Telephone Number	:	321-208-5094
Fax Number	:	321-327-8227

Authorized Official
Title or Position	:	OWNER
Name	:	JULIA NICHOLSON
Credential	:	LPN
Telephone Number	:	321-208-5094

Provider Enumeration Date	:	04/09/2021
Last Update Date	:	04/09/2021

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