Provider Demographics
NPI:1518586379
Name:ROYAL TREATMENT HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:ROYAL TREATMENT HOME HEALTH CARE LLC
Other - Org Name:ROYAL TREATMENT HOME HEALTH CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINSTARTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:252-653-5410
Mailing Address - Street 1:1410 BARRIER LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4730
Mailing Address - Country:US
Mailing Address - Phone:252-565-6674
Mailing Address - Fax:
Practice Address - Street 1:409 KING OLD BLVD.
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:NC
Practice Address - Zip Code:28580-2858
Practice Address - Country:US
Practice Address - Phone:252-565-6674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-13
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1968185Medicaid