Magnolia Manor Incorporated

NPI #1326244120 in Americus, Georgia

Provider Information

NPI Number: 1326244120
Entity Type: Organization
Organization Name: Magnolia Manor Incorporated
Subpart: Yes (part of a larger organization)
Parent Organization: MAGNOLIA MANOR INCORPORATED
Primary Specialty: Durable Medical Equipment & Medical Supplies - Parenteral & Enteral Nutrition
Enumeration Date: Jun 27, 2007
Last Updated: Mar 12, 2009

Practice Location

Address: 2001 S LEE ST
City: Americus
State: Georgia
ZIP Code: 31709-4715
Phone: (229) 924-9352

Authorized Official

Name: JERRY VICK
Title: VP FINANCE
Phone: (229) 924-9352

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies - Nursing Facility Supplies — Nursing Facility Supplies	332BN1400X
Durable Medical Equipment & Medical Supplies - Parenteral & Enteral Nutrition — Parenteral & Enteral Nutrition	332BP3500X	Primary

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