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Organization Active NPI

Reliable Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • Rochester, MN
National Provider Identifier
1134542673
Registry record updated Mar 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
RELIABLE MEDICAL SUPPLY LLC
Practice address
3555 9TH St NW
Suite 300
Rochester, MN 55901
Phone
(507) 218-3880
Fax
(507) 218-3881
NPI assigned
Feb 3, 2014
Last updated
Mar 16, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
RELIABLE MEDICAL SUPPLY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kiley Ann Russell
Title
Director of Payor Relations
Phone
(629) 252-8211

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Customized Equipment (DME) 332BC3200X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X
Oxygen Equipment & Supplies (DME) 332BX2000X
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

3555 9TH St NW
Suite 300
Rochester, MN 55901

Mailing address

9401 Winnetka Ave N
Brooklyn Park, MN 55445
Phone (763) 255-3800

Other identifiers 7

IdentifierTypeStateIssuer
8214389OtherMNMEDICA CHOICE
1030555OtherMNPREFERRED ONE
60677REOtherMNBLUE CROSS BLUE SHIELD
3184OtherMNHEALTHPARTNERS
105239OtherMNUCARE
8200081OtherMNMEDICA PRIMARY
915363200MedicaidMN

National Provider Directory

National Provider Directory
Tax ID family
Reliable Medical Supply LLC17 organizations share this tax ID, including this one
Part of
Reliable Medical Supply LLC

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

Locations

9401 Winnetka Ave N
Minneapolis, MN 55445
Phone (763) 255-3810

3555 9th St NW
Ste 300
Rochester, MN 55901
Phone (507) 218-3880

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678924800000",
    "number": "1134542673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9401 WINNETKA AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "55445",
            "telephone_number": "763-255-3800",
            "fax_number": "763-255-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3555 9TH ST NW",
            "address_2": "SUITE 300",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55901",
            "telephone_number": "507-218-3880",
            "fax_number": "507-218-3881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIABLE MEDICAL SUPPLY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RELIABLE MEDICAL SUPPLY, INC.",
        "enumeration_date": "2014-02-03",
        "last_updated": "2023-03-16",
        "certification_date": "2023-03-16",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KILEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "DIRECTOR OF PAYOR RELATIONS",
        "authorized_official_telephone_number": "629-252-8211"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA CHOICE",
            "identifier": "8214389",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1030555",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "60677RE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "3184",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "105239",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PRIMARY",
            "identifier": "8200081",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "915363200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.