Provider Demographics
NPI:1962263640
Name:ROYAL CRYSTAL NEMT INC
Entity type:Organization
Organization Name:ROYAL CRYSTAL NEMT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOBAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-622-4770
Mailing Address - Street 1:2505 PANOLA RD
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-4831
Mailing Address - Country:US
Mailing Address - Phone:770-404-0973
Mailing Address - Fax:
Practice Address - Street 1:2505 PANOLA RD
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-4831
Practice Address - Country:US
Practice Address - Phone:770-404-0973
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)