NPIMap

Organization Active NPI

Reliable Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • Bradenton, FL
National Provider Identifier
1629767066
Registry record updated Mar 17, 2026
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
3230 59TH Dr E Unit 101
Bradenton, FL 34203-1900
Phone
(941) 290-5007
Fax
(941) 491-5283
NPI assigned
May 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

3230 59TH Dr E Unit 101
Bradenton, FL 34203-1900

Mailing address

9495 Winnetka Ave N Ste 200
Brooklyn Park, MN 55445-1706
Phone (629) 282-8211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241216000502 FL DME Supplier - Medical Supply Company 0345367173 Practice locations: Bradenton, FL

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Reliable Medical Supply LLC3230 59TH Dr E, Bradenton, FL 34203-1900(941) 290-5007 Power Operated Vehicles (Scooters)|Wheelchairs (Standard Manual)|Wheelchairs (Standard Manual Related Accessories)|Wheelchairs (Standard Power)|Wheelchairs (Standard Power Related Accessories)|Wheelchairs (Complex Rehabilitative Manual)|Wheelchairs (Complex Rehab Manual Rel Accessories)|Wheelchairs… Does not accept assignmentParticipating since May 19, 2022

National Provider Directory

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

Other organizations with this tax ID 16

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

View all 16

Locations

3230 59th Dr E
Unit 101
Bradenton, FL 34203
Phone (941) 290-5007

NPI Registry JSON

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773705600000",
    "number": "1629767066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9495 WINNETKA AVE N STE 200",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554451706",
            "telephone_number": "629-282-8211",
            "fax_number": "763-255-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3230 59TH DR E UNIT 101",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342031900",
            "telephone_number": "941-290-5007",
            "fax_number": "941-491-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIABLE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-02",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KILEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "SENIOR 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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.