MAGNOLIA ENDOSCOPY CENTER, LLC; NPI #1740264274

Contact Information

MAGNOLIA ENDOSCOPY CENTER, LLC

3050 CORDER DR
CORINTH, MS 38834-6210

Phone: 662-284-9902
Fax: 662-284-9904
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Endoscopy	261QE0800X

Indicates primary specialty

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NPI Profile & details for MAGNOLIA ENDOSCOPY CENTER, LLC

NPI # 1740264274

LBN Legal business name MAGNOLIA ENDOSCOPY CENTER, LLC

Authorized official FREDRICK CORDER - (OWNER/PHYSICIAN/MEDICAL DIRECTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/29/2005

Last updated 09/08/2016 - About 10 years ago

Identifiers

Medicaid

00770615

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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