NPIMap

Organization Active NPI

Reliable Medical Supply LLC

  • Durable Medical Equipment & Medical Supplies
  • Austin, MN
National Provider Identifier
1710538152
Registry record updated Jan 27, 2022
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
313 2ND Ave NE
Austin, MN 55912-3430
Phone
(507) 433-9000
NPI assigned
Sep 26, 2019
Last updated
Jan 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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 1

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

Addresses

Primary practice location

313 2ND Ave NE
Austin, MN 55912-3430

Mailing address

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

Other names 1

  • Med City Mobility LLC Former legal business name

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

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1710538152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9401 WINNETKA AVENUE 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": "313 2ND AVE NE",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559123430",
            "telephone_number": "507-433-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIABLE MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-26",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med City Mobility LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Med City Mobility LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Austin, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.