Provider Demographics
NPI:1700546215
Name:RELIANCE MEDICAL CLINICS, PLLC
Entity Type:Organization
Organization Name:RELIANCE MEDICAL CLINICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KISHORE
Authorized Official - Middle Name:SHM
Authorized Official - Last Name:VARADA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:509-539-4273
Mailing Address - Street 1:1446 SPAULDING AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-4720
Mailing Address - Country:US
Mailing Address - Phone:509-420-5060
Mailing Address - Fax:509-420-5059
Practice Address - Street 1:1449 SPAULDING AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4707
Practice Address - Country:US
Practice Address - Phone:509-820-3940
Practice Address - Fax:509-820-3941
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RELIANCE MEDICAL CLINICS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility