MEDICARE: KEVIN REHAK, OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332H00000X	Eyewear Supplier	5994900001	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5994900001	OTHER		DME SUPPLIER

General Provider Information

NPI Number	:	1225227689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEVIN REHAK, OD

Provider Business Mailing Address
First Line	:	301 N LEWIS RD
Second Line	:	#165
City	:	ROYERSFORD
State	:	PA
Zip	:	19468-1531
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 N LEWIS RD
Second Line	:	#165
City	:	ROYERSFORD
State	:	PA
Zip	:	19468-1531
Country	:	US
Telephone Number	:	610-948-7000
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KEVIN REHAK
Credential	:	OD
Telephone Number	:	610-948-7000

Provider Enumeration Date	:	10/22/2007
Last Update Date	:	06/16/2008

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