Healthcare Provider Details

I. General information

NPI: 1033047675
Provider Name (Legal Business Name): RELIABLE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2217 FAIRFIELD PL
VALDOSTA GA
31602-2563
US

IV. Provider business mailing address

2217 FAIRFIELD PL
VALDOSTA GA
31602-2563
US

V. Phone/Fax

Practice location:
  • Phone: 863-223-9655
  • Fax:
Mailing address:
  • Phone: 863-223-9655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: LATOSHA CALLAWAY
Title or Position: CEO
Credential:
Phone: 863-223-9655