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General NPI Number Information
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NPI Number | 1205529039
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Entity Type | Organization
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Legal Business Name | MAGNOLIA MEDICAL TRANSPORTATION LLC
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Dates
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Enumeration Date | 05/29/2023
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Last Update Date | 05/29/2023
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Provider Practice Location Address
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Address Line | 69 SAINT STEPHENS RD
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City | SILVER CREEK
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State | MS
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Zip | 39663-2274
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Country | US
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Telephone | 601-419-1503
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 244
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City | SILVER CREEK
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State | MS
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Zip | 39663-0244
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | NATALIE MAGEE
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Credential |
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Telephone | 601-419-1503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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