Provider Demographics
NPI:1548510407
Name:REX PHYSICIANS LLC
Entity type:Organization
Organization Name:REX PHYSICIANS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SPONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-784-3245
Mailing Address - Street 1:790 SE CARY PKWY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5678
Mailing Address - Country:US
Mailing Address - Phone:919-784-7400
Mailing Address - Fax:919-784-7405
Practice Address - Street 1:790 SE CARY PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5678
Practice Address - Country:US
Practice Address - Phone:919-784-7400
Practice Address - Fax:919-784-7405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-18
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5921282Medicaid
NC2347365Medicare PIN