Provider Demographics
NPI:1386037695
Name:RELIABLE EQUIPMENT AND MEDICAL SUPPLIES, INC
Entity Type:Organization
Organization Name:RELIABLE EQUIPMENT AND MEDICAL SUPPLIES, INC
Other - Org Name:N/A
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:KANMUE
Authorized Official - Last Name:KOLLEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-440-5136
Mailing Address - Street 1:5701 SHINGLE CREEK PKWY
Mailing Address - Street 2:SUITE 470
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-2467
Mailing Address - Country:US
Mailing Address - Phone:763-442-5136
Mailing Address - Fax:763-219-8482
Practice Address - Street 1:5701 SHINGLE CREEK PKWY
Practice Address - Street 2:SUITE 470
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-2467
Practice Address - Country:US
Practice Address - Phone:763-442-5136
Practice Address - Fax:763-219-8482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies