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General NPI Number Information
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NPI Number | 1871047829
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Entity Type | Organization
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Legal Business Name | RELIANT MEDICAL GROUP, LLC
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Dates
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Enumeration Date | 08/08/2016
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Last Update Date | 08/15/2016
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Provider Practice Location Address
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Address Line | 3111 S VALLEY VIEW BLVD SUITE A-220
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City | LAS VEGAS
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State | NV
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Zip | 89102-8317
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Country | US
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Telephone | 702-719-9042
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Fax |
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Provider Business Mailing Address
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Address Line | 9831 VENUS LAKE CT
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City | LAS VEGAS
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State | NV
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Zip | 89178-5549
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Country | US
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Telephone | 702-719-9042
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ELAINE JANE CARDENAS-SMITH
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Credential |
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Telephone | 702-719-9042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | NV20161386806
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | NV20161386806
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License Number State | NV
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