Healthcare Provider Details

I. General information

NPI: 1932566650
Provider Name (Legal Business Name): RELIANT MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4315 TEXAS BLVD
TEXARKANA TX
75503-3024
US

IV. Provider business mailing address

PO BOX 14813
MONROE LA
71207-4813
US

V. Phone/Fax

Practice location:
  • Phone: 877-354-2688
  • Fax: 888-972-9703
Mailing address:
  • Phone: 877-354-2688
  • Fax: 888-972-9703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. BRAD M SMITH
Title or Position: CEO
Credential:
Phone: 318-322-8326