Provider Demographics
NPI:1235240953
Name:JOSEPH REZK
Entity Type:Organization
Organization Name:JOSEPH REZK
Other - Org Name:REZK MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:REZK
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:814-344-8944
Mailing Address - Street 1:1295 GRAND BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MONESSEN
Mailing Address - State:PA
Mailing Address - Zip Code:15062-1955
Mailing Address - Country:US
Mailing Address - Phone:724-361-3070
Mailing Address - Fax:724-361-3071
Practice Address - Street 1:1295 GRAND BLVD
Practice Address - Street 2:
Practice Address - City:MONESSEN
Practice Address - State:PA
Practice Address - Zip Code:15062-1955
Practice Address - Country:US
Practice Address - Phone:724-361-3070
Practice Address - Fax:724-361-3071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA80586214332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007774640001Medicaid
PA1184370002Medicare NSC