Provider Demographics
NPI:1639431463
Name:RELIANCE EMERGENT CARE, PLLC
Entity Type:Organization
Organization Name:RELIANCE EMERGENT CARE, PLLC
Other - Org Name:EDEN CARE, PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:KISHORE
Authorized Official - Middle Name:
Authorized Official - Last Name:VARADA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:509-420-0423
Mailing Address - Street 1:1446 SPAULDING PARK
Mailing Address - Street 2:STE. 101
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4707
Mailing Address - Country:US
Mailing Address - Phone:509-420-0423
Mailing Address - Fax:509-420-0424
Practice Address - Street 1:1446 SPAULDING PARK
Practice Address - Street 2:STE. 101
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4707
Practice Address - Country:US
Practice Address - Phone:509-420-0423
Practice Address - Fax:509-420-0424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care