Provider Demographics
NPI:1720265218
Name:RELIANCE MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:RELIANCE MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCDUFFIE
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:843-260-0922
Mailing Address - Street 1:900 S IRBY ST
Mailing Address - Street 2:SUITE 471
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5239
Mailing Address - Country:US
Mailing Address - Phone:843-260-0922
Mailing Address - Fax:843-629-5071
Practice Address - Street 1:202 3RD LOOP RD
Practice Address - Street 2:SUITE B
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-3795
Practice Address - Country:US
Practice Address - Phone:843-260-0922
Practice Address - Fax:843-629-5071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC6296570001Medicare NSC