MEDICARE: ROYAL HEALING & RESTORATION SERVICES, 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1922750934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROYAL HEALING & RESTORATION SERVICES, INC.

Provider Business Mailing Address
First Line	:	545 38TH AVE NE
Second Line	:
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-3802
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4111 CENTRAL AVE NE STE 208J
Second Line	:
City	:	COLUMBIA HEIGHTS
State	:	MN
Zip	:	55421-2953
Country	:	US
Telephone Number	:	612-459-0560
Fax Number	:	651-927-0324

Authorized Official
Title or Position	:	OWNER
Name	:	MOHAMED ABDI OSMAN
Credential	:
Telephone Number	:	124-590-5606

Provider Enumeration Date	:	01/20/2022
Last Update Date	:	09/17/2024

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