MAGNOLIA HOSPICE LLC NPI 1396169074

NPI Information

NPI: 1396169074
Provider Name: MAGNOLIA HOSPICE, LLC

Doing Business As: OPUSCARE OF GEORGIA

Classification: Hospice Care, Community Based - 251G00000X
Entity Type: Organization

CLIA Number: 11D2083748

Address:
1374 MANCHESTER DR NE
CONYERS, GA
ZIP 30012
Phone: (770) 483-9111
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MAGNOLIA HOSPICE, LLC is a hospice care community based in Conyers, GA. MAGNOLIA HOSPICE, LLC NPI is 1396169074. The provider is registered as an organization entity type.
The provider Is Doing Business As Opuscare Of Georgia.

The provider's business location address is:

1374 MANCHESTER DR NE
CONYERS, GA
ZIP 30012-881
Phone: (770) 483-9111
Fax: (877) 663-8423

The provider's authorized official is Ismael Roque-velasco .
The authorized official title is President/ceo and has the following contact phone number (305) 591-1606.

The CLIA number assigned to this NPI record is 11D2083748 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/14/2014 and was last updated on 5/17/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251G00000X	Hospice Care, Community Based				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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