RELIABLE MEDICAL SUPPLY LLC – Durable Medical Equipment & Medical Supplies, NPI 1093782609
Durable Medical Equipment & Medical Supplies
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for RELIABLE MEDICAL SUPPLY LLC
440 GREAT OAK DR
WAITE PARK, MN 563872505
Phone: (320) 259-5900
Fax: (320) 259-5901
Type: Location
9495 WINNETKA AVE N STE 200
BROOKLYN PARK, MN 554451618
Phone: (629) 282-8211
Fax: (763) 255-3972
Type: Mailing
Winnetka Avenue North, Brooklyn Park, Hennepin County, Minnesota, 55445, United States
BROOKLYN PARK, MN 55445
Phone: (763) 255-3800
Fax: (763) 255-3900
Type: Mailing
444, Great Oak Drive, Waite Park, Stearns County, Minnesota, 56387, United States
WAITE PARK, MN 56387
Phone: (320) 259-5900
Fax: (320) 259-5901
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-11-30 (194 days ago).
Enrollment records
1
Earliest due date
2025-11-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100930019418 | O | Medical Supply Company | MN | 2025-11-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 56387)
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