Magnolia Ambulance Service

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

122-05 Issued in GA

Legal business name

MAGNOLIA AMBULANCE SERVICE

Practice address

1129 Brett Dr SW
Suite a
Conyers, GA 30094-5998

Phone

(770) 761-7608

Fax

(770) 761-4078

NPI assigned

Jul 13, 2006

Organization subpart

No

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

Authorized official

Name

Chris M Hoffer

Title

Director

Phone

(404) 379-6261

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750306569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 BRETT DR SW",
            "address_2": "SUITE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945998",
            "telephone_number": "770-761-7608",
            "fax_number": "770-761-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 BRETT DR SW",
            "address_2": "SUITE A",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945998",
            "telephone_number": "770-761-7608",
            "fax_number": "770-761-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA AMBULANCE SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOFFER",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "404-379-6261"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "GA",
            "license": "122-05",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rashanda Mack
• Enricka Victoria Maddox, LPC
• Magan Maddox, LPN
• Janette Madry-Bower
• Madu Medical Group, P.C.
• Magnolia Hospice, LLC
• Mariny Margaret Mahabee-Harris, PH.D.
• Ritika Mahajan, M.D.
• Rajendra Maharaj, NP
• Casey Maher

• Land Ambulance in Conyers, GA
• Providers in Conyers, GA by specialty
• Land Ambulance in Georgia

• 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.