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General NPI Number Information
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NPI Number | 1275856148
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Entity Type | Organization
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Legal Business Name | REZK PHARMACY LLC
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Dates
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Enumeration Date | 03/08/2010
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Last Update Date | 02/13/2013
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Provider Practice Location Address
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Address Line | 204 SOUTH MAIN ST SUITE 100
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City | CARROLLTOWN
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State | PA
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Zip | 15722
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Country | US
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Telephone | 814-344-2200
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Fax | 814-344-2600
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Provider Business Mailing Address
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Address Line | PO BOX 369
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City | CARROLLTOWN
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State | PA
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Zip | 15722-0369
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Country | US
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Telephone | 814-344-2200
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Fax | 814-344-2600
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Authorized Official
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Title or Position | PHARMACIST
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Name | DR. RICHARD JOSEPH REZK
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Credential | PHARM D
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Telephone | 814-243-4915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | PP481996
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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