Organization Name: | MAGEE BENEVOLENT ASSOCIATION |
NPI Number: | 1356795827 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AMY S TOLLIVER (CEO) |
Mailing Address: | 300 3rd Ave Se Magee |
State: | MS US |
Postal Code: | 391113665 |
Phone Number: | 6018497702 |
Fax Number: | 6018490618 |
NPI Enumeration Date: | 04/20/2016 |
NPI Last Update Date: | 04/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QS1200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Sleep Disorder Diagnostic |
Taxonomy Definition: |