Healthcare Provider Details

I. General information

NPI: 1629665666
Provider Name (Legal Business Name): ROMANY REZK
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2020
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S HALL RD
ALCOA TN
37701-2639
US

IV. Provider business mailing address

2324 BISHOPS BRIDGE RD
KNOXVILLE TN
37922-6223
US

V. Phone/Fax

Practice location:
  • Phone: 865-983-0573
  • Fax:
Mailing address:
  • Phone: 804-517-4633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number41943
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: