Healthcare Provider Details

I. General information

NPI: 1982718243
Provider Name (Legal Business Name): RELIABLE MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151B HUDSON ST
HACKENSACK NJ
07601-6823
US

IV. Provider business mailing address

151B HUDSON ST
HACKENSACK NJ
07601-6823
US

V. Phone/Fax

Practice location:
  • Phone: 201-883-1515
  • Fax: 201-883-1530
Mailing address:
  • Phone: 201-883-1515
  • Fax: 201-883-1530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number332BX2000X
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0060283
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name: MICHAEL J GRABKO
Title or Position: CEO
Credential:
Phone: 717-657-2100