Magnolia Manor Incorporated

LBN: Magnolia Manor Incorporated
Magnolia Manor Incorporated is an health care organization with primary practice located at 2001 S Lee St , Americus GA 31709-4715. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Nursing Facility Supplies, Suppliers / Parenteral & Enteral Nutrition. Suppliers / Parenteral & Enteral Nutrition is the primary health care specialty. Magnolia Manor Incorporated can be contacted via phone (229) 924-9352, or through Vick, Jerry via phone (229) 924-9352.

Contact Information

Primary practice address
2001 S Lee St Americus GA 31709-4715
Phone: (229) 924-9352
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Vick, Jerry
Phone: (229) 924-9352

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Nursing Facility Supplies 332BN1400X
Suppliers / Parenteral & Enteral Nutrition 332BP3500X

Profile Details

NPI number 1326244120
LBN Legal business name Magnolia Manor Incorporated
DBA Doing business as
Authorized official Vick, Jerry
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 27th, 2007
Last updated Mar 12th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326244120 NPPES
Georgia MEDICAID 00040785C

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