Healthcare Provider Details

I. General information

NPI: 1770955346
Provider Name (Legal Business Name): RELIABLE MEDICAL TRANSPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2015
Last Update Date: 10/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11342 LANTANA REACH DR
RICHMOND TX
77406-1476
US

IV. Provider business mailing address

11342 LANTANA REACH DR
RICHMOND TX
77406-1476
US

V. Phone/Fax

Practice location:
  • Phone: 847-924-4101
  • Fax:
Mailing address:
  • Phone: 847-924-4101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number39035721
License Number StateTX

VIII. Authorized Official

Name: MR. JERIN KALAPPURAYIL
Title or Position: OWNER
Credential:
Phone: 847-924-4101