MEDICARE: RELI MEDICAL TRANSPORTATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343800000X	Secured Medical Transport (VAN)

General Provider Information

NPI Number	:	1972914414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELI MEDICAL TRANSPORTATION

Provider Business Mailing Address
First Line	:	3653 BRIARGROVE LN
Second Line	:	1513
City	:	DALLAS
State	:	TX
Zip	:	75287-6136
Country	:	US
Telephone Number	:	972-802-9217
Fax Number	:

Provider Business Practice Location Address
First Line	:	3653 BRIARGROVE LN
Second Line	:	1513
City	:	DALLAS
State	:	TX
Zip	:	75287-6136
Country	:	US
Telephone Number	:	972-802-9217
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	DONALD GRAY SR.
Credential	:
Telephone Number	:	972-802-9217

Provider Enumeration Date	:	05/19/2014
Last Update Date	:	05/19/2014

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