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Organization
MAGNOLIA MEDICAL, LLC
Active
Organization
MAGNOLIA MEDICAL, LLC
Active
Parent organization
MAGNOLIA MEDICAL, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MAGNOLIA MEDICAL, LLC
Authorized official
MR. DAVID HYDE (MANAGING PARTNER)
(225) 763-1314
Entity
Organization
Contact information
Practice address
400 CARTER ST, VIDALIA, LA 71373-3307
(318) 336-6088
(318) 336-6095
Mailing address
304 HIGHLAND BLVD, SUITE B, NATCHEZ, MS 39120-4624
(601) 442-6493
(601) 442-0999
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
09/18/2013
Last updated
09/18/2013
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