Healthcare Provider Details

I. General information

NPI: 1336443712
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

4414 LAKE BOONE TRL STE 505
RALEIGH NC
27607-7521
US

IV. Provider business mailing address

4414 LAKE BOONE TRL STE 505
RALEIGH NC
27607-7521
US

V. Phone/Fax

Practice location:
  • Phone: 919-784-2300
  • Fax: 919-784-2301
Mailing address:
  • Phone: 919-784-2300
  • Fax: 919-784-2301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

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