Provider Demographics
NPI:1609531367
Name:ROYAL CROWN RX
Entity Type:Organization
Organization Name:ROYAL CROWN RX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-327-9063
Mailing Address - Street 1:2120 E FIRE TOWER RD
Mailing Address - Street 2:SUITE 107- 1123
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-8013
Mailing Address - Country:US
Mailing Address - Phone:252-327-9063
Mailing Address - Fax:
Practice Address - Street 1:4320 E 10TH STREET EXT STE D
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-0838
Practice Address - Country:US
Practice Address - Phone:252-327-9063
Practice Address - Fax:855-684-1959
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOC QUEEN PL. , LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-07
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier