Healthcare Provider Details

I. General information

NPI: 1710411160
Provider Name (Legal Business Name): REX HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 BLUE RIDGE ROAD SUITE 201
RALEIGH NC
27607-6477
US

IV. Provider business mailing address

2800 BLUE RIDGE ROAD SUITE 201
RALEIGH NC
27607-6477
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-7110
  • Fax: 919-784-7111
Mailing address:
  • Phone: 919-784-7110
  • Fax: 919-784-7111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIA JAYOUSSI
Title or Position: VP FINANCE COMMUNITY PHYSICIANS
Credential:
Phone: 440-476-1713