Provider Demographics
NPI:1972126407
Name:RELIANT HOME MEDICAL SUPPLIES AND EQUIPMENT LLC
Entity Type:Organization
Organization Name:RELIANT HOME MEDICAL SUPPLIES AND EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:SHAWNCEE
Authorized Official - Middle Name:
Authorized Official - Last Name:VASSER-CUNNINGHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:662-436-7141
Mailing Address - Street 1:134 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MS
Mailing Address - Zip Code:39730-2710
Mailing Address - Country:US
Mailing Address - Phone:662-304-5082
Mailing Address - Fax:662-304-5017
Practice Address - Street 1:134 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MS
Practice Address - Zip Code:39730-2710
Practice Address - Country:US
Practice Address - Phone:662-304-5082
Practice Address - Fax:662-304-5017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-19
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies