Provider Demographics
NPI:1154790640
Name:FRANK A REZK
Entity type:Organization
Organization Name:FRANK A REZK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
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 1:900 BRYAN ST
Practice Address - Street 2:SUITE 6A
Practice Address - City:HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:16652-2413
Practice Address - Country:US
Practice Address - Phone:814-506-9920
Practice Address - Fax:814-506-9921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-15
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA3000009280332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA152805OtherUNISON
PA0017226640002Medicaid
PA1505986OtherGATEWAY
PA040020700OtherDOL
PA297884OtherHIGHMARK
PA1535665OtherUMWA
PA152805OtherUNISON