Provider Demographics
NPI:1649540881
Name:MCGEE, REX SMITH JR
Entity type:Individual
Prefix:MR
First Name:REX
Middle Name:SMITH
Last Name:MCGEE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:REX
Other - Middle Name:S
Other - Last Name:MCGEE
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:5175 BROOKBERRY PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27104-3784
Mailing Address - Country:US
Mailing Address - Phone:336-245-3009
Mailing Address - Fax:336-245-3008
Practice Address - Street 1:4996 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27104-4506
Practice Address - Country:US
Practice Address - Phone:336-774-8420
Practice Address - Fax:336-774-8583
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-05
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12212183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist