Healthcare Provider Details

I. General information

NPI: 1821859885
Provider Name (Legal Business Name): RELIANT MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2024
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CROSLEY ST STE 1
WEST MONROE LA
71291-2913
US

IV. Provider business mailing address

PO BOX 14813
MONROE LA
71207-4813
US

V. Phone/Fax

Practice location:
  • Phone: 318-322-8326
  • Fax:
Mailing address:
  • Phone: 318-322-8326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. BRADFORD MICHAEL SMITH
Title or Position: CEO
Credential:
Phone: 318-322-8326