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General NPI Number Information
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NPI Number | 1740432194
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Entity Type | Organization
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Legal Business Name | MAGNOLIA CARE MEDICAL SUPPLY
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 8730 IMPERIAL HWY
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City | DOWNEY
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State | CA
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Zip | 90242-3906
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Country | US
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Telephone | 562-923-5600
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Fax | 562-923-5667
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Provider Business Mailing Address
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Address Line | 8730 IMPERIAL HWY
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City | DOWNEY
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State | CA
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Zip | 90242-3906
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Country | US
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Telephone | 562-923-5600
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Fax | 562-923-5667
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MISS DIANA LYNN LOVE
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Credential |
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Telephone | 562-923-5600
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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 | 49998
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License Number State | CA
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