Organization
RELIABLE MEDICAL SUPPLY LLC
Active
Parent organization
RELIABLE MEDICAL SUPPLY, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
RELIABLE MEDICAL SUPPLY, INC.
Authorized official
KILEY ANN RUSSELL (DIRECTOR OF PAYOR RELATIONS)
(629) 252-8211
Entity
Organization
Contact information
Practice address
3555 9TH ST NW, SUITE 300, ROCHESTER, MN 55901
(507) 218-3880
(507) 218-3881
Mailing address
9401 WINNETKA AVE N, BROOKLYN PARK, MN 55445
(763) 255-3800
(763) 255-3900
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1030555
PREFERRED ONE
MN
01
—
105239
UCARE
MN
01
—
3184
HEALTHPARTNERS
MN
01
—
60677RE
BLUE CROSS BLUE SHIELD
MN
01
—
8200081
MEDICA PRIMARY
MN
01
—
8214389
MEDICA CHOICE
MN
05
—
915363200
—
MN
Enumeration date
02/03/2014
Last updated
03/16/2023
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