Organization
MAGNOLIA LEGACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLYSHA MARSHALL (OWNER)
(985) 352-4215
Entity
Organization
Contact information
Practice address
2737 W WASHINGTON CENTER RD LOT 13, FORT WAYNE, IN 46818-1489
(985) 352-4215
Mailing address
2737 W WASHINGTON CENTER RD LOT 13, FORT WAYNE, IN 46818-1489
(985) 352-4215
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
05/05/2026
Last updated
05/05/2026
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