Provider Demographics
NPI:1114417821
Name:ROYAL HOME CARE
Entity Type:Organization
Organization Name:ROYAL HOME CARE
Other - Org Name:ROYAL HOME CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR,RN
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:518-762-9350
Mailing Address - Street 1:506 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12095-1217
Mailing Address - Country:US
Mailing Address - Phone:518-762-9350
Mailing Address - Fax:518-848-3262
Practice Address - Street 1:506 N MARKET ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:NY
Practice Address - Zip Code:12095-1217
Practice Address - Country:US
Practice Address - Phone:518-762-9350
Practice Address - Fax:518-848-3262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health