Provider Demographics
NPI:1639481021
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:
Authorized Official - Credentials:
Authorized Official - Phone:814-344-8994
Mailing Address - Street 1:1830 OAKLAND AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3359
Mailing Address - Country:US
Mailing Address - Phone:724-471-3008
Mailing Address - Fax:724-471-3009
Practice Address - Street 1:1830 OAKLAND AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-3359
Practice Address - Country:US
Practice Address - Phone:724-471-3008
Practice Address - Fax:724-471-3009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007774640021Medicaid
PA1184370015Medicare NSC