Provider Demographics
NPI:1316377054
Name:ROYAL HEALTH CARE SUPPLY LLC
Entity Type:Organization
Organization Name:ROYAL HEALTH CARE SUPPLY LLC
Other - Org Name:ROYAL HEALTH CARE SUPPLY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAWIT
Authorized Official - Middle Name:
Authorized Official - Last Name:GIZAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-675-3731
Mailing Address - Street 1:50 S PICKETT ST STE 225
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-7203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 S PICKETT ST STE 225
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-7203
Practice Address - Country:US
Practice Address - Phone:301-675-3731
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies