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MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. , NPI 1407853716

Clinic/Center in SHREVEPORT, LA

Last Updated on : Aug 18,2011

MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. , NPI 1407853716

About MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. (NPI 1407853716)


MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. is a Clinic/Center in SHREVEPORT, United States with a focus in Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) .

1407853716 is NPI number of MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC..

MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC.'s primary taxonomy code based on NPI Lookup is 261QR0401X with license number . This taxonomy code refers to Clinic/Center.

MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. current practice location address is 2005 CRESWELL AVE, SHREVEPORT, LA. MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. can be reached out via phone at 318-676-0705 and via fax at 318-676-0709 .

You can also correspond with MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. through mail at mailing address 2005 CRESWELL AVE, SHREVEPORT, LA, United States. Mailing address contact number is 318-676-0705.

The enumeration date of MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. is 30-Jun-2005. The provider is registered as an Organization and the NPI record was last updated 11 years ago.

The authorized official of MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. is Dewarrent Brantley (Ceo/President). Dewarrent Brantley can be reached at 3186760705.

1407853716 NPI Information

Basic NPI information of MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. (NPI 1407853716) is provided below.

Name MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC.
National Provider Id (NPI) 1407853716
Entity Type Organization
Practice Address 2005 CRESWELL AVE,
SHREVEPORT, LA, United States
Practice Telephone 318-676-0705
Practice Fax Number 318-676-0709
Mailing Address 2005 CRESWELL AVE ,
SHREVEPORT, LA, United States
Mailing Telephone 318-676-0705
Mailing Fax Number 318-676-0709
Enumeration Date 30-Jun-2005
Last Updated Date 18-Aug-2011

MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. (NPI 1407853716) Primary Taxonomy Information

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs, the license data is associated to the taxonomy code.

Primary Taxonomy Code Clasification License Number License State
Y 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)

Additional Identifiers

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type/Code Identifier State Identifier Issuer
1159310 MEDICAID (05) LA
========= Other (non-Medicare) (01) LA Tri-CareSouthwest
=========0 Other (non-Medicare) (01) LA BluecrossBluesheild of La

MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. (NPI 1407853716) Office Location

Office location of MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. is provided in the Google maps below.

Providers in same location

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NPI Name Taxonomy Address Enumeration date
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1902963929 SHANNON BURTON PECK Psychologist, Clinical 510 E STONER AVE,
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1275690125 COMMCARE LOUISIANA Durable Medical Equipment & Medical Supplies 5201A SHREVEPORT HIGHWAY,
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1215094040 PATRICK TIMOTHY GALLAGHER Emergency Medicine 2049 PEPPER RIDGE DR,
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1427115153 SPENCER HEATH LOVITT Specialist 9432 KROETZ DR,
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02-Jan-2007
1750685954 GREGORY BRIGOLA Chiropractor 4626 S CLYDE MORRIS BLVD STE 1,
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02-Jan-2011
1972924363 BIOMEDICAL RESEARCH FOUNDATION OF NORTHWEST LOUISIANA Pharmacy, Nuclear Pharmacy PO BOX 38050,
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02-Jan-2014
1578008421 CANDACE BRACY Counselor, Mental Health 3501 CHAMPION LAKE BLVD, APT 401
SHREVEPORT, LA, United States
02-Jan-2017
1891202776 ALLCARE OF LOUISIANA, INC. Community/Behavioral Health 4615 MONKHOUSE DR STE 116,
SHREVEPORT, LA, United States
02-Jan-2018
1194232959 AVIANCE SHANTEL SMITH Counselor, Mental Health 9403 MANSFIELD RD,
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02-Jan-2018
1801369897 KENYA SHANTELL MAESHACK Case Manager/Care Coordinator 8120 CARDIGAN WAY,
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02-Jan-2019
1184197188 LAQUEISHA NAQUAE WILLIAMS Specialist/Technologist, Athletic Trainer 3406 RIVIERA ST,
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02-Jan-2019
1871571778 WELLNECESSITIES ,INC. Clinic/Center, Sleep Disorder Diagnostic 8835 LINE AVENUE, SUITE 500
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03-Jan-2006
1295713956 WELLNECESSITIES, INC. Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies 8835 LINE AVENUE, SUITE 500
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1801874698 TODD F BAKER Emergency Medicine PO BOX 32600,
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1437216710 POWELL MEDICAL CENTER MINISTISTRIES INC Point of Service 515 PIERRE AVE,
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03-Jan-2007
1922165232 DONALD RAY THOMAS Counselor, Addiction (Substance Use Disorder) 2038 LINE AVE,
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1053478206 BRIAN DOLIN BASINGER Dentist, General Practice 816 PIERREMONT RD,
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03-Jan-2007
1124185384 ALLEGIANCE MEDICAL SUPPLY, LLC Durable Medical Equipment & Medical Supplies 1532 IRVING PL,
SHREVEPORT, LA, United States
03-Jan-2007

How to check whether NPI 1063496693 is valid?

The following video explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

FAQs

Whose NPI Number is 1407853716?

1407853716 is the NPI number of MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC..

Where is MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. located?

MAGNOLIA COMPREHENSIVE OUTPATIENT REHABILIATION FACILITY INC. is located at 2005 CRESWELL AVE, SHREVEPORT, LA.

NPI number meaning

Field Name Field Value
NPI 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Entity Type Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Business Mailing Address The mailing address of the provider being identified contains First line, Second Line, City name, State name, Postal code, and Country code.
Provider Business Mailing Address Telephone Number The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address fax number''.
Provider Business Practice Location Address Telephone Number The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number The fax number associated with the location address of the provider being identified.
Provider Enumeration Date The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date The date that a record was last updated or changed.
Authorized Official Telephone Number The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy Taxonomy Description of the Healthcare Provider.
Provider License Number Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code Provider License Number State Code #1
Healthcare Provider Primary Taxonomy Switch Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
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