Healthcare Provider Details

I. General information

NPI: 1922710755
Provider Name (Legal Business Name): RELIANCE MEDICAL TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2022
Last Update Date: 02/08/2023
Certification Date: 02/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3036 E BIRCH AVE
VISALIA CA
93292-6823
US

IV. Provider business mailing address

3036 E BIRCH AVE
VISALIA CA
93292-6823
US

V. Phone/Fax

Practice location:
  • Phone: 559-786-0767
  • Fax:
Mailing address:
  • Phone: 559-786-0767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MR. DERRICK LITTLE
Title or Position: PRESIDENT
Credential:
Phone: 559-786-0767