Provider Demographics
NPI:1649412867
Name:REX HOSPITAL INC
Entity type:Organization
Organization Name:REX HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:6602 KNIGHTDALE BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-6526
Mailing Address - Country:US
Mailing Address - Phone:919-747-5210
Mailing Address - Fax:919-747-5211
Practice Address - Street 1:6602 KNIGHTDALE BOULEVARD
Practice Address - Street 2:SUITE 102
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-7130
Practice Address - Country:US
Practice Address - Phone:919-747-5210
Practice Address - Fax:919-747-5211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2025-01-31
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
NC0270QOtherBCBS
NC021M6OtherBCBS
NC235099RMedicare PIN
NC5911527Medicaid