Organization
MAGNOLIA MEDICAL SUPPLIES AND EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHNNY MACK HARDY (CEO)
(662) 301-1013
Entity
Organization
Contact information
Practice address
301 W MAIN ST, SENATOBIA, MS 38668-2146
(662) 301-1013
(662) 301-1015
Mailing address
PO BOX 85, TUNICA, MS 38676-0085
(662) 301-1013
(662) 357-7621
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Enumeration date
08/11/2007
Last updated
08/11/2007
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