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General NPI Number Information
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NPI Number | 1710653233
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Entity Type | Organization
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Legal Business Name | RELIABLE MEDICAL SUPPLY LLC
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 01/27/2022
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Provider Practice Location Address
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Address Line | 381 RIVERSIDE DR STE 230
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City | FRANKLIN
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State | TN
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Zip | 37064-8934
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Country | US
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Telephone | 763-255-3800
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Fax |
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Provider Business Mailing Address
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Address Line | 9401 WINNETKA AVENUE N.
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City | BROOKLYN PARK
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State | MN
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Zip | 55445
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Country | US
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Telephone | 763-255-3800
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Fax | 763-255-3900
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Authorized Official
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Title or Position | CONTROLLER
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Name | THOMAS J. CARLSON
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Credential |
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Telephone | 763-255-3800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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