Provider Demographics
NPI:1770955346
Name:RELIABLE MEDICAL TRANSPORT LLC
Entity type:Organization
Organization Name:RELIABLE MEDICAL TRANSPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KALAPPURAYIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-924-4101
Mailing Address - Street 1:11342 LANTANA REACH DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-1476
Mailing Address - Country:US
Mailing Address - Phone:847-924-4101
Mailing Address - Fax:
Practice Address - Street 1:11342 LANTANA REACH DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-1476
Practice Address - Country:US
Practice Address - Phone:847-924-4101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39035721343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)