Healthcare Provider Details
I. General information
NPI: 1972807352
Provider Name (Legal Business Name): REX HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/29/2010
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4420 LAKE BOONE TRL
RALEIGH NC
27607-7505
US
IV. Provider business mailing address
4420 LAKE BOONE TRL
RALEIGH NC
27607-7505
US
V. Phone/Fax
- Phone: 919-784-3298
- Fax:
- Phone: 919-784-3298
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QH0002X |
| Taxonomy | Hospice and Palliative Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0002X |
| Taxonomy | Hospice and Palliative Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARIA
JAYOUSSI
Title or Position: VP FINANCE COMMUNITY PHYSICIANS
Credential:
Phone: 440-476-1713