Provider Demographics
NPI:1518058924
Name:RELIANT CARE MEDICAL SERVICES
Entity Type:Organization
Organization Name:RELIANT CARE MEDICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNDOO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-543-3803
Mailing Address - Street 1:9200 WATSON RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-1528
Mailing Address - Country:US
Mailing Address - Phone:314-543-3800
Mailing Address - Fax:314-543-3880
Practice Address - Street 1:9200 WATSON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63126-1528
Practice Address - Country:US
Practice Address - Phone:314-543-3800
Practice Address - Fax:314-543-3880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
0421560001Medicare ID - Type Unspecified