Provider Demographics
NPI:1710913835
Name:REX HOSPITAL INC
Entity Type:Organization
Organization Name:REX HOSPITAL INC
Other - Org Name:REX PEDIATRICS OF CARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CORPORATE FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:LEGAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-784-6394
Mailing Address - Street 1:1515 SW CARY PKWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6224
Mailing Address - Country:US
Mailing Address - Phone:919-387-3160
Mailing Address - Fax:919-387-3165
Practice Address - Street 1:1515 SW CARY PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6224
Practice Address - Country:US
Practice Address - Phone:919-387-3160
Practice Address - Fax:919-387-3165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2016-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5858708OtherAETNA/USHEALTH
NC890266LMedicaid
NC0266LOtherBCBS
=========019OtherTRICARE/CHAMPUS