Healthcare Provider Details

I. General information

NPI: 1124694567
Provider Name (Legal Business Name): REX HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2021
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 BLUE RIDGE RD STE 204
RALEIGH NC
27607-6477
US

IV. Provider business mailing address

2800 BLUE RIDGE RD STE 204
RALEIGH NC
27607-6477
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-3200
  • Fax: 919-784-7399
Mailing address:
  • Phone: 919-784-3200
  • Fax: 919-784-7399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal 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