Healthcare Provider Details

I. General information

NPI: 1720169725
Provider Name (Legal Business Name): REX ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 10/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 EAST MAIN ST
WESSINGTON SPRINGS SD
57382-0327
US

IV. Provider business mailing address

PO BOX 327 202 E MAIN STREET
WESSINGTON SPRINGS SD
57382
US

V. Phone/Fax

Practice location:
  • Phone: 605-539-1421
  • Fax: 605-539-1151
Mailing address:
  • Phone: 605-539-1421
  • Fax: 605-539-1151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number100-1870
License Number StateSD

VIII. Authorized Official

Name: JOSEPH REX
Title or Position: OWNER/PHARMACIST
Credential:
Phone: 605-539-1421