Provider Demographics
NPI:1154854842
Name:ROYAL HOMECARE AGENCY
Entity Type:Organization
Organization Name:ROYAL HOMECARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:OBIANUJU
Authorized Official - Middle Name:G
Authorized Official - Last Name:AGUOLU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-622-3762
Mailing Address - Street 1:10212 AUTUMN CIR
Mailing Address - Street 2:
Mailing Address - City:STREETSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:44241-4317
Mailing Address - Country:US
Mailing Address - Phone:216-509-6431
Mailing Address - Fax:
Practice Address - Street 1:1717 BRITTAIN RD
Practice Address - Street 2:SUITE 313
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44310-1846
Practice Address - Country:US
Practice Address - Phone:330-622-3762
Practice Address - Fax:330-655-1622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health