1346484243 NPI number — JOSEPH REZK

Table of content: (NPI 1346484243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346484243 NPI number — JOSEPH REZK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOSEPH REZK
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
REZK MEDICAL SUPPLY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346484243
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 N FRONT ST
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
PHILIPSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16866-2303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-343-5281
Provider Business Mailing Address Fax Number:
814-343-5282

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 N FRONT ST
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
PHILIPSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16866-2303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-343-5281
Provider Business Practice Location Address Fax Number:
814-343-5282
Provider Enumeration Date:
04/23/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
REZK
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
814-344-8994

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)