Provider Demographics
NPI:1689116402
Name:REX PHARMACY INC
Entity Type:Organization
Organization Name:REX PHARMACY INC
Other - Org Name:REX PHARMACY (LTC)
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:712-243-2110
Mailing Address - Street 1:1607 E 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-1910
Mailing Address - Country:US
Mailing Address - Phone:712-243-2110
Mailing Address - Fax:712-243-2064
Practice Address - Street 1:1607 E 7TH ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-1910
Practice Address - Country:US
Practice Address - Phone:712-243-2110
Practice Address - Fax:712-243-2064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IA543336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2166068OtherPK