Provider Demographics
NPI:1902232275
Name:ROYAL CARE AMBULANCE CORP
Entity Type:Organization
Organization Name:ROYAL CARE AMBULANCE CORP
Other - Org Name:ROYAL CARE AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AWAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BASHIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-736-2799
Mailing Address - Street 1:32 GIFFORD AVE
Mailing Address - Street 2:APT # 2-B
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1962
Mailing Address - Country:US
Mailing Address - Phone:201-736-2799
Mailing Address - Fax:201-795-3937
Practice Address - Street 1:32 GIFFORD AVE
Practice Address - Street 2:APT # 2-B
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1962
Practice Address - Country:US
Practice Address - Phone:201-736-2799
Practice Address - Fax:201-795-3937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0912024341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========000Medicaid