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General NPI Number Information
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NPI Number | 1720905292
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Entity Type | Organization
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Legal Business Name | MAGNOLIA STAR HEALTH SERVICES LLC
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Dates
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Enumeration Date | 07/03/2026
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Last Update Date | 07/03/2026
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Provider Practice Location Address
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Address Line | 971 US HIGHWAY 202 N STE N
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City | BRANCHBURG
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State | NJ
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Zip | 08876-3757
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Country | US
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Telephone | 732-518-3900
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Fax |
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Provider Business Mailing Address
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Address Line | 105 TIVOLI GARDENS RD STE V
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1528
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Country | US
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Telephone | 623-292-2356
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Fax |
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | MRS. OPEYEMI ADEGBESAN
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Credential |
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Telephone | 623-292-2356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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