MAGNOLIA BLOOMS PCH,LLC


Address: 1250 Nicholsville Rd Nw, Monroe, GA 30656-3469
Phone: 6784582011

MAGNOLIA BLOOMS PCH,LLC (NPI# 1750536819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1750536819
Entity Type Organization
Organization Name MAGNOLIA BLOOMS PCH,LLC
Practice Address 1250 Nicholsville Rd Nw
Monroe
GA 30656-3469
Practice Telephone 6784582011
Mailing Telephone 6784582011
Enumeration Date 2008-11-17
Last Update Date 2008-11-17
Authorized Official Name MRS. SANDY WAGES BALLARD (OWNER)
Authorized Official Telephone 6784582011
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QH0100X Clinic/Center
Specialization: Health Service
147-01-013-1 GA Ambulatory Health Care Facilities

Office Location

Street Address 1250 NICHOLSVILLE RD NW
City MONROE
State GA
Zip Code 30656-3469

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1871732040 Natalie H Grooms Occupational Therapist 1045 Old Mill Trce, Monroe, GA 30656-4379 2009-02-11
1881770949 Mary Hinch Physical Therapist 1045 Old Mill Trce, Monroe, GA 30656-4379 2006-10-31
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Taxonomy Information

Taxonomy Code 261QH0100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Health Service

Taxonomy Definition

Definition to come...
Notes: [7/1/2006: modified title]

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Competitor

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City MONROE
Zip Code 30656

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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