Provider Demographics
NPI:1982290870
Name:IMPERIAL MOBILE HEALTHCARE, LLC
Entity Type:Organization
Organization Name:IMPERIAL MOBILE HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP.MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ROSLA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:ROYAL
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:561-346-2050
Mailing Address - Street 1:6208 W STONEPATH GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-3727
Mailing Address - Country:US
Mailing Address - Phone:561-346-2050
Mailing Address - Fax:
Practice Address - Street 1:6208 W STONEPATH GARDEN DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-3727
Practice Address - Country:US
Practice Address - Phone:561-346-2050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IMPERIAL MOBILE HEALTHCARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-12-15
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health