Basic Information
Provider Information
NPI: 1083216618
EntityType: 2
ReplacementNPI:  
OrganizationName: REX HOSPITAL INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: NORTH CAROLINA OB/GYN & MIDWIFERY
OtherOrganizationType: 3
OtherLastName:  
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Mailing Information
Address1: 781 AVENT FERRY RD STE 106
Address2:  
City: HOLLY SPRINGS
State: NC
PostalCode: 275407776
CountryCode: US
TelephoneNumber: 9195676133
FaxNumber: 9195676134
Practice Location
Address1: 781 AVENT FERRY RD STE 106
Address2:  
City: HOLLY SPRINGS
State: NC
PostalCode: 275407776
CountryCode: US
TelephoneNumber: 9195676133
FaxNumber: 9195676134
Other Information
ProviderEnumerationDate: 11/09/2020
LastUpdateDate: 04/20/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: HOOLEY
AuthorizedOfficialFirstName: MEGHAN
AuthorizedOfficialMiddleName: ELIZABETH
AuthorizedOfficialTitleorPosition: DIRECTOR OF CORPORATE FINANCE
AuthorizedOfficialTelephone: 9197847711
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 04/20/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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