NPIMap

Organization Active NPI

Magnolia Medical LLC

  • Prosthetic/Orthotic Supplier
  • Shreveport, LA
National Provider Identifier
1124482617
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
MAGNOLIA MEDICAL LLC
Practice address
1950 E 70TH St
Suite H
Shreveport, LA 71105-5345
Phone
(318) 219-5219
Fax
(888) 542-4810
NPI assigned
Apr 11, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tina R Alexander
Title
General Manager
Phone
(601) 334-2599

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

1950 E 70TH St
Suite H
Shreveport, LA 71105-5345

Mailing address

304 Highland Blvd
Suite B
Natchez, MS 39120-4624
Phone (601) 442-6493

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Medical LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1950 E 70th St
Ste H
Shreveport, LA 71105
Phone (318) 219-5219

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1124482617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 HIGHLAND BLVD",
            "address_2": "SUITE B",
            "city": "NATCHEZ",
            "state": "MS",
            "postal_code": "391204624",
            "telephone_number": "601-442-6493",
            "fax_number": "601-445-0999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 E 70TH ST",
            "address_2": "SUITE H",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055345",
            "telephone_number": "318-219-5219",
            "fax_number": "888-542-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-11",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "601-334-2599"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.