Magnolia Family Clinic
Family Medicine in Rienzi, MS. Organization (NPI-2).
NPI number1508303348
StatusActive
Last updated in NPPESJul 15, 2022
Details
- NPI
- 1508303348
- Entity type
- Organization (NPI-2)
- Legal business name
- Magnolia Family Clinic
- Organization subpart
- Yes
- Enumeration date
- Jan 31, 2017
- Certification date
- Jul 15, 2022
- Last updated
- Jul 15, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Practice location
82 Main StRienzi, MS 38865-9144
Phone 662-293-6699 · Fax 662-293-6698
Mailing address
401 Alcorn Dr Ste 2cCorinth, MS 38834-9073
Phone 662-293-7618 · Fax 662-293-4358
Authorized official
Deonne Henry
Executive Director
6622931076
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