Provider Demographics
NPI:1437141371
Name:REZ INC
Entity Type:Organization
Organization Name:REZ INC
Other - Org Name:OWL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:REZNICEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-437-7200
Mailing Address - Street 1:213 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544-1707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:213 N 13TH ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-1707
Practice Address - Country:US
Practice Address - Phone:641-437-7200
Practice Address - Fax:641-437-7300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-17
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2027502OtherPK
MO603116708Medicaid
MO623116712Medicaid
IA0076059Medicaid
MO603116708Medicaid