Healthcare Provider Details

I. General information

NPI: 1871047829
Provider Name (Legal Business Name): RELIANT MEDICAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2016
Last Update Date: 08/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3111 S VALLEY VIEW BLVD SUITE A-220
LAS VEGAS NV
89102-8317
US

IV. Provider business mailing address

9831 VENUS LAKE CT
LAS VEGAS NV
89178-5549
US

V. Phone/Fax

Practice location:
  • Phone: 702-719-9042
  • Fax:
Mailing address:
  • Phone: 702-719-9042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberNV20161386806
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License NumberNV20161386806
License Number StateNV

VIII. Authorized Official

Name: MS. ELAINE JANE CARDENAS-SMITH
Title or Position: PRESIDENT
Credential:
Phone: 702-719-9042