Provider Demographics
NPI:1700060084
Name:ROYAL CARE MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:ROYAL CARE MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:BASHIR
Authorized Official - Last Name:ELTAYEB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:545-712-9803
Mailing Address - Street 1:2205 AMBASSADOR RD NE
Mailing Address - Street 2:#225
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-2724
Mailing Address - Country:US
Mailing Address - Phone:505-712-9803
Mailing Address - Fax:
Practice Address - Street 1:2205 AMBASSADOR RD NE
Practice Address - Street 2:#225
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2724
Practice Address - Country:US
Practice Address - Phone:505-712-9803
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-22
Last Update Date:2007-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)