| Organization Name: | MAGNOLIA MEDICAL LLC |
| NPI Number: | 1124482617 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TINA R ALEXANDER (GENERAL MANAGER) |
| Mailing Address: | 1950 E 70th St Suite H Shreveport |
| State: | LA US |
| Postal Code: | 711055345 |
| Phone Number: | 3182195219 |
| Fax Number: | 8885424810 |
| NPI Enumeration Date: | 04/11/2016 |
| NPI Last Update Date: | 04/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |