Provider Demographics
NPI:1861479297
Name:ROYAL QUALITY MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:ROYAL QUALITY MEDICAL EQUIPMENT INC
Other - Org Name:ROYAL QUALITY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUGICA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-884-3715
Mailing Address - Street 1:6708 NW 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-3032
Mailing Address - Country:US
Mailing Address - Phone:305-884-3715
Mailing Address - Fax:305-884-3716
Practice Address - Street 1:6708 NW 72ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-3032
Practice Address - Country:US
Practice Address - Phone:305-884-3715
Practice Address - Fax:305-884-3716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FLPH241523336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1051832OtherNCPDP PROVIDER IDENTIFICATION NUMBER
FL026873900Medicaid
5061130001Medicare NSC