Provider Demographics
NPI:1205546488
Name:ROYALTY HEALTH SERVICES LLC
Entity type:Organization
Organization Name:ROYALTY HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:OSEREME
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBOIFO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-639-2495
Mailing Address - Street 1:1422 SERVICE BERRY WAY
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-6052
Mailing Address - Country:US
Mailing Address - Phone:240-639-2495
Mailing Address - Fax:
Practice Address - Street 1:1422 SERVICE BERRY WAY
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-6052
Practice Address - Country:US
Practice Address - Phone:240-639-2495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)