Provider Demographics
NPI:1124586722
Name:ROYALTY CARE LLC
Entity Type:Organization
Organization Name:ROYALTY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATARA
Authorized Official - Middle Name:RANIECE
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-437-1457
Mailing Address - Street 1:PO BOX 11027
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63135-0027
Mailing Address - Country:US
Mailing Address - Phone:314-649-5421
Mailing Address - Fax:336-890-8523
Practice Address - Street 1:4625 LINDELL BLVD # 214
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-3725
Practice Address - Country:US
Practice Address - Phone:314-649-5421
Practice Address - Fax:336-890-8523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO25573926OtherMOID