Provider Demographics
NPI:1831741230
Name:THE ROYALTY OF HEALTHCARE LLC
Entity type:Organization
Organization Name:THE ROYALTY OF HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:WOMACK
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:470-778-1148
Mailing Address - Street 1:PO BOX 1877
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-7242
Mailing Address - Country:US
Mailing Address - Phone:470-778-1148
Mailing Address - Fax:404-393-8763
Practice Address - Street 1:1775 PARKER RD SE STE 200
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30094-6654
Practice Address - Country:US
Practice Address - Phone:470-778-1148
Practice Address - Fax:404-393-8763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-15
Last Update Date:2019-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health