Provider Demographics
NPI:1699872432
Name:REX PHARMACEUTICALS INC
Entity type:Organization
Organization Name:REX PHARMACEUTICALS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RASIK
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-224-1336
Mailing Address - Street 1:6853 S HALSTED ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60621-1896
Mailing Address - Country:US
Mailing Address - Phone:773-224-1336
Mailing Address - Fax:773-224-1888
Practice Address - Street 1:6853 S HALSTED ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60621-1896
Practice Address - Country:US
Practice Address - Phone:773-224-1336
Practice Address - Fax:773-224-1888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IL0540111733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2021389OtherPK
2021389OtherPK
IL=========001Medicaid