Provider Demographics
NPI:1164464541
Name:REX HOSPITAL, INC.
Entity Type:Organization
Organization Name:REX HOSPITAL, INC.
Other - Org Name:REX HOME SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:ZUKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-784-6422
Mailing Address - Street 1:1500 SUNDAY DR
Mailing Address - Street 2:SUITE 113
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-5151
Mailing Address - Country:US
Mailing Address - Phone:919-784-4442
Mailing Address - Fax:919-784-4548
Practice Address - Street 1:1500 SUNDAY DR
Practice Address - Street 2:SUITE 113
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-5151
Practice Address - Country:US
Practice Address - Phone:919-784-4442
Practice Address - Fax:919-784-4548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-12
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC0422 944099251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3407176Medicaid
NC3417176Medicaid
NC3407176Medicaid