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General NPI Number Information
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NPI Number | 1043395544
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Entity Type | Organization
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Legal Business Name | MAGNOLIA'S PERSONAL CARE MEDICAL DURABLE EQUIPMENT INC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 205 CROUCHET ST
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City | CARENCRO
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State | LA
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Zip | 70520
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Country | US
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Telephone | 337-232-4351
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Fax | 337-232-4352
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Provider Business Mailing Address
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Address Line | 920 WEST PINHOOK ROAD SUITE 229
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City | LAFAYETTE
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State | LA
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Zip | 70503
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Country | US
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Telephone | 337-232-4351
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Fax | 337-232-4352
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Authorized Official
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Title or Position | OWNER/DIRECTER
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Name | MRS. EMILIE L DUHON
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Credential |
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Telephone | 337-232-4351
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 12278
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License Number State | LA
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