Organization
PENN HOME MEDICAL SUPPLY CO., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANK A REZK (PRESIDENT)
(814) 948-2058
Entity
Organization
Contact information
Practice address
1307 FEDERAL ST, PITTSBURGH, PA 15212-4769
(412) 321-2901
(412) 321-2903
Mailing address
1704 PHILADELPHIA AVE, PO BOX 1031, NORTHERN CAMBRIA, PA 15714-1180
(814) 948-2058
(814) 948-7139
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
3000007985
PA
332BC3200X
Customized Equipment (DME)
3000007985
PA
332BN1400X
Nursing Facility Supplies (DME)
3000007985
PA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
3000007985
PA
332BX2000X
Oxygen Equipment & Supplies (DME)
3000007985
PA
335E00000X
Prosthetic/Orthotic Supplier
3000007985
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017226640002
—
PA
01
—
040020700
DOL
PA
01
—
152805
UNISON HEALTH PLAN
PA
01
—
1535665
UMWA
PA
01
—
297884
HIGHMARK BCBS
PA
Enumeration date
08/16/2007
Last updated
08/16/2007
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