Organization
RELIABLE MEDICAL SUPPLY LLC
Active
Other names
Med City Mobility LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KILEY ANN RUSSELL (SENIOR DIRECTOR OF PAYOR RELATIONS)
(629) 252-8211
Entity
Organization
Contact information
Practice address
200 8TH AVE NW, FARIBAULT, MN 55021-5068
(507) 334-2602
(507) 334-7574
Mailing address
9495 WINNETKA AVE N STE 200, BROOKLYN PARK, MN 55445-1618
(629) 282-8211
(763) 255-3972
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)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
915363200
—
MN
Enumeration date
09/24/2019
Last updated
04/17/2024
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