Magnolia Medical Group Inc

LBN: Magnolia Medical Group Inc
Magnolia Medical Group Inc is an health care organization with primary practice located at 800 Pelham Rd Third Floor - Physical Therapy Department, Greenville SC 29615-3300. The organization recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, Speech, Language and Hearing Service Providers / Speech-Language Pathologist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is the primary health care specialty. Magnolia Medical Group Inc can be contacted via phone (864) 752-3357, or through Cortina, Victor M via phone (864) 621-5646.

Contact Information

Primary practice address
800 Pelham Rd Third Floor - Physical Therapy Department Greenville SC 29615-3300
Phone: (864) 752-3357
Fax: (678) 840-2112
Website:
Map and Directions
Authorized official contact:
Name: Cortina, Victor M Physical Therapist (PT)
Phone: (864) 621-5646

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X South Carolina
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X South Carolina
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X South Carolina

Profile Details

NPI number 1386629558
LBN Legal business name Magnolia Medical Group Inc
DBA Doing business as
Authorized official Cortina, Victor M Physical Therapist (PT)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 11th, 2005
Last updated Apr 18th, 2012 - about 12 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 1386629558 NPPES
South Carolina MEDICAID GP3940

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