Organization
FRANK A REZK
Active
Other names
Penn Home Medical Supply Co., LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRANK A. REZK (PRESIDENT/CEO)
(814) 471-0627
Entity
Organization
Contact information
Practice address
1075 FRANKLIN ST, JOHNSTOWN, PA 15905-4303
(814) 254-4218
(814) 254-4431
Mailing address
PO BOX 337, EBENSBURG, PA 15931-0337
(814) 471-0627
(814) 471-0639
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
PA
332BC3200X
Customized Equipment (DME)
—
PA
332BN1400X
Nursing Facility Supplies (DME)
—
PA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
PA
332BX2000X
Oxygen Equipment & Supplies (DME)
—
PA
335E00000X
Prosthetic/Orthotic Supplier
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017226640002
—
PA
01
—
040020700
DOL
PA
01
—
1505986
GATEWAY
PA
01
—
152805
UNISON
PA
01
—
297884
HIGHMARK
PA
01
—
704483
UPMC
PA
Enumeration date
07/06/2009
Last updated
05/12/2016
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