Basic Information
| Provider Information | |||||||||
| NPI: | 1548909146 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | REX HOSPITAL INC | ||||||||
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| OtherOrganizationName: | NORTH CAROLINA NEUROLOGY | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5221 PARAMOUNT PKWY STE 420 | ||||||||
| Address2: | |||||||||
| City: | MORRISVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275605491 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9849741256 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4207 LAKE BOONE TRL STE 100 | ||||||||
| Address2: | |||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276076685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197841410 | ||||||||
| FaxNumber: | 9197841409 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2022 | ||||||||
| LastUpdateDate: | 07/02/2022 | ||||||||
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| AuthorizedOfficialLastName: | HOOLEY | ||||||||
| AuthorizedOfficialFirstName: | MEGHAN | ||||||||
| AuthorizedOfficialMiddleName: | ELIZABETH | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR OF CORPORATE FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 9197847711 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 07/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.