Magnolia Blooms PCH,LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

147-01-013-1 Issued in GA

Legal business name

MAGNOLIA BLOOMS PCH,LLC

Practice address

1250 Nicholsville Rd NW
Monroe, GA 30656-3469

Phone

(678) 458-2011

NPI assigned

Nov 17, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Sandy Wages Ballard

Title

Owner

Phone

(678) 458-2011

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226880000000",
    "number": "1750536819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 NICHOLSVILLE RD NW",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306563469",
            "telephone_number": "678-458-2011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 NICHOLSVILLE RD NW",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306563469",
            "telephone_number": "678-458-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA BLOOMS PCH,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-17",
        "last_updated": "2008-11-17",
        "status": "A",
        "authorized_official_last_name": "BALLARD",
        "authorized_official_first_name": "SANDY",
        "authorized_official_middle_name": "WAGES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-458-2011",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "GA",
            "license": "147-01-013-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nydia Jeanette Long, LDO
• Lorraine Driver
• Darrin Wendell Lowe II, DO
• James Matthew Lype I
• M Evelyn Host Home
• Richard Mahieu, MED., ATC
• Heather Marie Goodwin Mancebo
• Nancy A Manley, EDD, LPC
• Joseph Danso Manu, LPC
• Marilyn Digamon Beltran

• Health Service Clinic/Center in Monroe, GA
• Providers in Monroe, GA by specialty
• Health Service Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2008; 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.