Provider Demographics
NPI:1346820107
Name:ROYAL G SNACKS, INC.
Entity Type:Organization
Organization Name:ROYAL G SNACKS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ERNNEUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-244-5920
Mailing Address - Street 1:PO BOX 291468
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33687-1468
Mailing Address - Country:US
Mailing Address - Phone:305-244-5920
Mailing Address - Fax:
Practice Address - Street 1:8504 E ADAMO DR STE 115
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-3515
Practice Address - Country:US
Practice Address - Phone:813-898-8795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services