Magnifique, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MAGNIFIQUE, INC.

Doing business as

Supreme Medical Supply

Practice address

730 S Blake St
Pine Bluff, AR 71603-1822

Phone

(870) 534-2224

Fax

(870) 534-1226

NPI assigned

Jun 18, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Carla Regina Thomas, RN

Title

Manager

Phone

(870) 534-2224

Specialties & licenses 1

Addresses

Other names 1

• SUPREME MEDICAL SUPPLY Doing business as

Locations

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396780987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 S BLAKE ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716031822",
            "telephone_number": "870-534-2224",
            "fax_number": "870-534-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 S BLAKE ST",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716031822",
            "telephone_number": "870-534-2224",
            "fax_number": "870-534-1226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNIFIQUE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "REGINA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "870-534-2224",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUPREME MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charles D Mabry, M.D.
• Scott Aaron Mabry, CADC, CCS
• Caylin Mack
• Christopher Mack, MHPP
• Lori Maddox, MS RD LD
• Sadeem Mahmood, M.D.
• John Makary, MD
• Mohammed Malik, M.D.
• Sharon D Mallett
• Gary W Manly, CRNA

• Durable Medical Equipment & Medical Supplies in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Durable Medical Equipment & Medical Supplies in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.