Healthcare Provider Details

I. General information

NPI: 1720020035
Provider Name (Legal Business Name): RELIANCE MEDICAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/20/2024
Certification Date: 08/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 E AVENUE E
ALPINE TX
79830-4816
US

IV. Provider business mailing address

149 N WILLIS ST STE 1
ABILENE TX
79603-6924
US

V. Phone/Fax

Practice location:
  • Phone: 432-837-7455
  • Fax: 432-837-7455
Mailing address:
  • Phone: 325-692-7443
  • Fax: 325-692-3566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0041243
License Number StateTX

VIII. Authorized Official

Name: CAROLINA OGANYAN
Title or Position: VICE PRESIDENT
Credential:
Phone: 972-346-1813