Healthcare Provider Details

I. General information

NPI: 1235093063
Provider Name (Legal Business Name): RELIANT HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14440 CHERRY LANE CT STE 219
LAUREL MD
20707-4946
US

IV. Provider business mailing address

4103 BRIDLE RIDGE RD
UPPER MARLBORO MD
20772-8049
US

V. Phone/Fax

Practice location:
  • Phone: 301-257-5788
  • Fax:
Mailing address:
  • Phone: 301-257-5788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EMMANUEL OYENIYI OGUNMOLA
Title or Position: PRESIDENT
Credential:
Phone: 301-257-5788