Provider Demographics
NPI:1720020035
Name:RELIANCE MEDICAL, INC
Entity Type:Organization
Organization Name:RELIANCE MEDICAL, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-346-1813
Mailing Address - Street 1:149 N WILLIS ST STE 1
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79603-6924
Mailing Address - Country:US
Mailing Address - Phone:325-692-7443
Mailing Address - Fax:325-692-3566
Practice Address - Street 1:502 E AVENUE E
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:TX
Practice Address - Zip Code:79830-4816
Practice Address - Country:US
Practice Address - Phone:432-837-7455
Practice Address - Fax:432-837-7455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0041243332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX111348203Medicaid