Provider Demographics
NPI:1649201542
Name:REX HOSPITAL INC
Entity Type:Organization
Organization Name:REX HOSPITAL INC
Other - Org Name:REX EXPRESS CARE OF WAKEFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE COMMUNITY PHYSICIANS
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAYOUSSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-476-1713
Mailing Address - Street 1:11200 GOVERNOR MANLY WAY STE 114
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-7360
Mailing Address - Country:US
Mailing Address - Phone:919-570-7660
Mailing Address - Fax:919-570-7661
Practice Address - Street 1:11200 GOVERNOR MANLY WAY
Practice Address - Street 2:SUITE 114
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-6830
Practice Address - Country:US
Practice Address - Phone:919-570-7660
Practice Address - Fax:919-570-7661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC017K5OtherBCBS
7286844OtherAETNA/USHEALTH
NC017K5OtherBCBS
7286844OtherAETNA/USHEALTH
NCD555Medicare PIN