Provider Demographics
NPI:1104140961
Name:RELIANCE BOTTLE GAS
Entity type:Organization
Organization Name:RELIANCE BOTTLE GAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-392-3781
Mailing Address - Street 1:6025 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-1061
Mailing Address - Country:US
Mailing Address - Phone:419-473-1374
Mailing Address - Fax:419-473-8785
Practice Address - Street 1:6025 SECOR RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-1061
Practice Address - Country:US
Practice Address - Phone:419-473-1374
Practice Address - Fax:419-473-8785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0950529Medicaid
0542250001Medicare NSC