# MAGNOLIA MEDICAL COMPANY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043769862
- **Authorized official:** PRADEEP RAJ RAI (MEDICAL DIRECTOR)
- **Authorized official phone:** (303) 209-5115

## Contact information

- **Practice address:** 2925 E COLFAX AVE, DENVER, CO 80206-1604
- **Practice address phone:** (303) 209-5115
- **Practice address fax:** (720) 638-5562
- **Mailing address:** PO BOX 29605, DEPT \# 800927, PHOENIX, AZ 85038-9605
- **Mailing address phone:** (303) 209-5115
- **Mailing address fax:** (720) 638-5562

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 207RA0401X | Addiction Medicine (Internal Medicine) Physician | — | — | Yes |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 291U00000X | Clinical Medical Laboratory | 06D2121590 | CO | — |

## Other

- **Enumeration date:** 09/22/2016
- **Last updated:** 02/17/2026