Healthcare Provider Details

I. General information

NPI: 1689116402
Provider Name (Legal Business Name): REX PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2016
Last Update Date: 07/16/2020
Certification Date: 07/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 E 7TH ST
ATLANTIC IA
50022-1910
US

IV. Provider business mailing address

1607 E 7TH ST
ATLANTIC IA
50022-1910
US

V. Phone/Fax

Practice location:
  • Phone: 712-243-2110
  • Fax: 712-243-2064
Mailing address:
  • Phone: 712-243-2110
  • Fax: 712-243-2064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number54
License Number StateIA

VIII. Authorized Official

Name: JOSHUA BORER
Title or Position: PRESIDENT
Credential: PHARMD
Phone: 712-243-2110