Provider Demographics
NPI:1548207095
Name:RELIABLE HEALTHCARE
Entity Type:Organization
Organization Name:RELIABLE HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:CHAVIS
Authorized Official - Last Name:WATFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-332-7955
Mailing Address - Street 1:117 RAILROAD ST N
Mailing Address - Street 2:
Mailing Address - City:AHOSKIE
Mailing Address - State:NC
Mailing Address - Zip Code:27910-3040
Mailing Address - Country:US
Mailing Address - Phone:252-332-7955
Mailing Address - Fax:252-332-6788
Practice Address - Street 1:117 RAILROAD ST N
Practice Address - Street 2:
Practice Address - City:AHOSKIE
Practice Address - State:NC
Practice Address - Zip Code:27910-3040
Practice Address - Country:US
Practice Address - Phone:252-332-7955
Practice Address - Fax:252-332-6788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC1302251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600371Medicaid
NC3408610Medicaid