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Organization
MAGNOLIA MEDICAL COMPANY
Active
Organization
MAGNOLIA MEDICAL COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRADEEP RAJ RAI (MEDICAL DIRECTOR)
(303) 209-5115
Entity
Organization
Contact information
Practice address
2925 E COLFAX AVE, DENVER, CO 80206-1604
(303) 209-5115
(720) 638-5562
Mailing address
PO BOX 29605, DEPT # 800927, PHOENIX, AZ 85038-9605
(303) 209-5115
(720) 638-5562
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
NULL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
291U00000X
Clinical Medical Laboratory
06D2121590
CO
Other
Enumeration date
09/22/2016
Last updated
02/17/2026
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