Provider Demographics
NPI:1619080660
Name:FRANK A REZK
Entity Type:Organization
Organization Name:FRANK A REZK
Other - Org Name:PENN HOME MEDICAL SUPPLY CO.,LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:A
Authorized Official - Last Name:REZK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-471-0627
Mailing Address - Street 1:657 INDUSTRIAL PARK RD
Mailing Address - Street 2:PO BOX 337
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-4111
Mailing Address - Country:US
Mailing Address - Phone:814-471-0627
Mailing Address - Fax:814-471-0639
Practice Address - Street 1:1704 PHILADELPHIA AVE
Practice Address - Street 2:
Practice Address - City:NORTHERN CAMBRIA
Practice Address - State:PA
Practice Address - Zip Code:15714-1180
Practice Address - Country:US
Practice Address - Phone:814-948-2058
Practice Address - Fax:814-948-7139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1505986OtherGATEWAY
PA1535665OtherUMWA
PA152805OtherUNISON
PA297884OtherHIGHMARK
PA0017226640002Medicaid
PA040020700OtherDOL
PA152805OtherUNISON