Provider Demographics
NPI:1356733406
Name:RELIABLE MEDICAL SUPPLY CENTER, INC
Entity type:Organization
Organization Name:RELIABLE MEDICAL SUPPLY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VAHAB
Authorized Official - Middle Name:
Authorized Official - Last Name:AGHAI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:844-881-0880
Mailing Address - Street 1:17835 VENTURA BLVD
Mailing Address - Street 2:SUITE 211
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3634
Mailing Address - Country:US
Mailing Address - Phone:844-881-0880
Mailing Address - Fax:
Practice Address - Street 1:17835 VENTURA BLVD
Practice Address - Street 2:SUITE 211
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3634
Practice Address - Country:US
Practice Address - Phone:844-881-0880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7364280001Medicare NSC