Organization
MAGNOLIA HOSPITALITY INC.
Active
Other names
Magnolia Critical Care and Internal Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
RACHNA PURI (OFFICE MANAGER)
(573) 874-3235
Entity
Organization
Contact information
Practice address
2475 BROADWAY BLUFFS DRIVE, STE. 301, COLUMBIA, MO 65201-8128
(573) 874-3235
(573) 817-5917
Mailing address
2475 BROADWAY BLUFFS DRIVE, STE. 301, COLUMBIA, MO 65201-8128
(573) 874-3235
(573) 817-5917
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
509179305
—
MO
Enumeration date
09/27/2006
Last updated
11/19/2012
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