Healthcare Provider Details

I. General information

NPI: 1386037695
Provider Name (Legal Business Name): RELIABLE EQUIPMENT AND MEDICAL SUPPLIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2015
Last Update Date: 03/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 SHINGLE CREEK PKWY SUITE 470
BROOKLYN CENTER MN
55430-2467
US

IV. Provider business mailing address

5701 SHINGLE CREEK PKWY SUITE 470
BROOKLYN CENTER MN
55430-2467
US

V. Phone/Fax

Practice location:
  • Phone: 763-442-5136
  • Fax: 763-219-8482
Mailing address:
  • Phone: 763-442-5136
  • Fax: 763-219-8482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN KANMUE KOLLEH
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 763-440-5136