Provider Demographics
NPI: | 1023635356 |
---|---|
Name: | ROYALTY HOME CARE HEALTH CARE BUSINESS |
Entity type: | Organization |
Organization Name: | ROYALTY HOME CARE HEALTH CARE BUSINESS |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MONICA |
Authorized Official - Middle Name: | M |
Authorized Official - Last Name: | CONLEY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 228-697-3417 |
Mailing Address - Street 1: | 1073 ACADIAN DR STE B |
Mailing Address - Street 2: | |
Mailing Address - City: | GULFPORT |
Mailing Address - State: | MS |
Mailing Address - Zip Code: | 39507-3538 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 228-990-9366 |
Mailing Address - Fax: | 877-206-2707 |
Practice Address - Street 1: | 1073 ACADIAN DR STE B |
Practice Address - Street 2: | |
Practice Address - City: | GULFPORT |
Practice Address - State: | MS |
Practice Address - Zip Code: | 39507-3538 |
Practice Address - Country: | US |
Practice Address - Phone: | 228-990-9366 |
Practice Address - Fax: | 877-206-2707 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-07-02 |
Last Update Date: | 2020-10-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 224900000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Mastectomy Fitter | Group - Multi-Specialty | |
No | 374U00000X | Nursing Service Related Providers | Home Health Aide | Group - Multi-Specialty | |
No | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health | Group - Multi-Specialty |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
No | 246RP1900X | Technologists, Technicians & Other Technical Service Providers | Technician, Pathology | Phlebotomy | Group - Multi-Specialty |
No | 246ZE0500X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | EEG | Group - Multi-Specialty |
No | 3747A0650X | Nursing Service Related Providers | Technician | Attendant Care Provider | Group - Multi-Specialty |
No | 376J00000X | Nursing Service Related Providers | Homemaker | Group - Multi-Specialty | |
No | 376K00000X | Nursing Service Related Providers | Nurse's Aide | Group - Multi-Specialty |