Provider Demographics
NPI:1457716631
Name:RELIANT SPECIALTY LLC
Entity Type:Organization
Organization Name:RELIANT SPECIALTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SATYANARAYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALIVETI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:860-223-0522
Mailing Address - Street 1:46 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-4305
Mailing Address - Country:US
Mailing Address - Phone:860-223-0522
Mailing Address - Fax:860-223-0822
Practice Address - Street 1:46 BROAD ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-4305
Practice Address - Country:US
Practice Address - Phone:860-223-0522
Practice Address - Fax:860-223-0822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCSW.00029723336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy