Healthcare Provider Details

I. General information

NPI: 1518052612
Provider Name (Legal Business Name): REX PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 10/18/2021
Certification Date: 10/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 MAIN ST
MANNING IA
51455
US

IV. Provider business mailing address

1607 E. 7TH ST
ATLANTIC IA
50022
US

V. Phone/Fax

Practice location:
  • Phone: 712-655-2665
  • Fax: 712-655-2295
Mailing address:
  • Phone: 712-243-2110
  • Fax: 712-243-2064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number16
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

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