Healthcare Provider Details

I. General information

NPI: 1104823715
Provider Name (Legal Business Name): RELIABLE MEDICAL PRODUCTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2005
Last Update Date: 06/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W DEER VALLEY RD STE 1
PHOENIX AZ
85027-2117
US

IV. Provider business mailing address

PO BOX 43965
PHOENIX AZ
85080-3965
US

V. Phone/Fax

Practice location:
  • Phone: 623-434-5585
  • Fax: 623-434-5595
Mailing address:
  • Phone: 623-434-5585
  • Fax: 623-434-5595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number07-579814-D
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number07-579814-D
License Number StateAZ

VIII. Authorized Official

Name: GLORIA A KNUTSON
Title or Position: PRESIDENT
Credential:
Phone: 623-434-5585