Provider Demographics
NPI:1255507752
Name:ROYALTY TRANSPORTATION, LLC
Entity Type:Organization
Organization Name:ROYALTY TRANSPORTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVIDSON
Authorized Official - Middle Name:
Authorized Official - Last Name:ETIENNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-523-3239
Mailing Address - Street 1:4 GARLAND LN
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1724
Mailing Address - Country:US
Mailing Address - Phone:516-792-1095
Mailing Address - Fax:516-792-1097
Practice Address - Street 1:4 GARLAND LN
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1724
Practice Address - Country:US
Practice Address - Phone:516-792-1095
Practice Address - Fax:516-792-1097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)