Healthcare Provider Details

I. General information

NPI: 1942239538
Provider Name (Legal Business Name): REX HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 BLUE RIDGE RD STE 203
RALEIGH NC
27607-6423
US

IV. Provider business mailing address

2901 BLUE RIDGE RD STE 203
RALEIGH NC
27607-6423
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-6818
  • Fax: 919-784-6828
Mailing address:
  • Phone: 919-784-6818
  • Fax: 919-784-6828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State

VIII. Authorized Official

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