| Royalty Health Services Llc | |
|
1422 Service Berry Way Odenton MD 21113-6052 | |
| (240) 639-2495 | |
| Not Available |
| Full Name | Royalty Health Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1422 Service Berry Way, Odenton, Maryland |
| Authorized Official Name and Position | Osereme Agboifo (PROVIDER) |
| Authorized Official Contact | 2406392495 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Royalty Health Services Llc 1422 Service Berry Way Odenton MD 21113-6052 Ph: (240) 639-2495 | Royalty Health Services Llc 1422 Service Berry Way Odenton MD 21113-6052 Ph: (240) 639-2495 |
| NPI Number | 1205546488 |
|---|---|
| Provider Enumeration Date | 11/29/2022 |
| Last Update Date | 11/29/2022 |
| Certification Date | 11/29/2022 |
| Medicare PECOS PAC ID | 5092188961 |
|---|---|
| Medicare Enrollment ID | O20230224001555 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205546488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Osereme Nora Agboifo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750989042 PECOS PAC ID: 4183032881 Enrollment ID: I20210419001216 |
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