# MAGNOLIA AMBULANCE SERVICE

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

## Provider details

- **NPI number:** 1750306569
- **Authorized official:** CHRIS M HOFFER (DIRECTOR)
- **Authorized official phone:** (404) 379-6261

## Contact information

- **Practice address:** 1129 BRETT DR SW, SUITE A, CONYERS, GA 30094-5998
- **Practice address phone:** (770) 761-7608
- **Practice address fax:** (770) 761-4078
- **Mailing address:** 1129 BRETT DR SW, SUITE A, CONYERS, GA 30094-5998
- **Mailing address phone:** (770) 761-7608
- **Mailing address fax:** (770) 761-4078

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 122-05 | GA | Yes |

## Other

- **Enumeration date:** 07/13/2006
- **Last updated:** 08/22/2020