Magnolia Manor of Tupelo
NPI #1558545210 in Tupelo, Mississippi
Provider Information
- NPI Number
- 1558545210
- Entity Type
- Organization
- Organization Name
- Magnolia Manor of Tupelo
- Primary Specialty
- Preferred Provider Organization
- Enumeration Date
- Dec 18, 2007
- Last Updated
- Dec 18, 2007
Practice Location
- Address
- 1514 COUNTY ROAD 41
- City
- Tupelo
- State
- Mississippi
- ZIP Code
- 38801-0681
- Phone
- (662) 842-6776
Authorized Official
- Name
- MS. DONNA PHARR
- Title
- EXECUTIVE DIRECTOR
- Phone
- (662) 842-6776
Specialties & Taxonomy Codes
| Specialty |
|---|
| Preferred Provider Organization |
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