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Organization
RELIANT MEDICAL LLC
Active
Organization
RELIANT MEDICAL LLC
Active
Other names
Reliant Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD SMITH (CEO)
(318) 322-8326
Entity
Organization
Contact information
Practice address
3532 MANOR DR STE 4, VICKSBURG, MS 39180-5629
(877) 354-2688
(318) 322-0998
Mailing address
PO BOX 2293, MONROE, LA 71207-2293
(877) 354-2688
(318) 354-0998
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
12953/ 2.6
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143959
PK
—
Enumeration date
01/21/2014
Last updated
07/08/2016
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