# REX HOSPITAL INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rex Family Practice of Wakefield
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750319729
- **Authorized official:** BERNADETTE M SPONG (CFO)
- **Authorized official phone:** (919) 784-3245

## Contact information

- **Practice address:** 11200 GOVERNOR MANLY WAY, SUITE 205, RALEIGH, NC 27614-6830
- **Practice address phone:** (919) 570-7700
- **Practice address fax:** (919) 570-7701
- **Mailing address:** 11200 GOVERNOR MANLY WAY, SUITE 205, RALEIGH, NC 27614-6830
- **Mailing address phone:** (919) 570-7700
- **Mailing address fax:** (919) 570-7701

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/29/2006
- **Last updated:** 04/28/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 014XV | BCBS | NC |
| 01 | — | 7607516 | AETNA | — |
| 05 | — | 89014XV | — | NC |