Organization
MAGNOLIA MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA R ALEXANDER (GENERAL MANAGER)
(601) 334-2599
Entity
Organization
Contact information
Practice address
1950 E 70TH ST, SUITE H, SHREVEPORT, LA 71105-5345
(318) 219-5219
(888) 542-4810
Mailing address
304 HIGHLAND BLVD, SUITE B, NATCHEZ, MS 39120-4624
(601) 442-6493
(601) 445-0999
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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