MEDICARE: MAGNA VENTURES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	344600000X	Taxi
2	347B00000X	Bus
3	347C00000X	Private Vehicle
4	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1871367599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAGNA VENTURES LLC

Provider Business Mailing Address
First Line	:	201 RIO GRANDE DR
Second Line	:
City	:	WAXAHACHIE
State	:	TX
Zip	:	75165-2460
Country	:	US
Telephone Number	:	417-496-5391
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 RIO GRANDE DR
Second Line	:
City	:	WAXAHACHIE
State	:	TX
Zip	:	75165-2460
Country	:	US
Telephone Number	:	417-496-5391
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MICHAEL KUBIN
Credential	:
Telephone Number	:	417-496-5391

Provider Enumeration Date	:	11/13/2023
Last Update Date	:	11/13/2023

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Directions to “MAGNA VENTURES LLC ” Practice Location

Language	Start Address	Practice Location

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