Healthcare Provider Details

I. General information

NPI: 1639431463
Provider Name (Legal Business Name): RELIANCE EMERGENT CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2012
Last Update Date: 06/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1446 SPAULDING PARK STE. 101
RICHLAND WA
99352-4707
US

IV. Provider business mailing address

1446 SPAULDING PARK STE. 101
RICHLAND WA
99352-4707
US

V. Phone/Fax

Practice location:
  • Phone: 509-420-0423
  • Fax: 509-420-0424
Mailing address:
  • Phone: 509-420-0423
  • Fax: 509-420-0424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KISHORE VARADA
Title or Position: CHAIRMAN
Credential: PA-C
Phone: 509-420-0423