MEDICARE: MAGNOLIA CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1114813532
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAGNOLIA CARE LLC

Provider Business Mailing Address
First Line	:	5625 SUNNYSIDE ROAD
Second Line	:	3235
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46235
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10841 SPRING GREEN DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46229-3535
Country	:	US
Telephone Number	:	317-869-7887
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DEMIA WHITE
Credential	:
Telephone Number	:	317-333-1927

Provider Enumeration Date	:	06/13/2025
Last Update Date	:	11/17/2025

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Directions to “MAGNOLIA CARE LLC ” Practice Location

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