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General NPI Number Information
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NPI Number | 1568618288
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Entity Type | Organization
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Legal Business Name | JACQUELINE MAGEE
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Dates
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Enumeration Date | 08/13/2008
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Last Update Date | 10/17/2008
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Provider Practice Location Address
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Address Line | 8880 GERMANTOWN RD STE 502
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-8561
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Country | US
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Telephone | 662-890-6939
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Fax |
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Provider Business Mailing Address
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Address Line | 8880 GERMANTOWN RD STE 502
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-8561
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Country | US
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Telephone | 662-890-6939
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JACQUELINE YVETTE MAGEE
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Credential | RN, BSN
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Telephone | 662-890-6939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 166
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License Number State | MS
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