National Provider Identifier Database

MAGNOLIA PEC LLC
Medically Fragile Infants and Children Day Care

An entity, facility, or distinct part of a facility specially equipped and staffed to provide care for medically fragile children with varied and complex care needs (e.g., enteral or parental feeding, ostomy care, respiratory/ventilator care, medications and therapies, etc.).


Contact Information

MAGNOLIA PEC, LLC
404 N 12TH AVE
LAUREL, MS39440-3876
Phone: 601-682-1250
Fax: 601-682-1256
Website:
Specialty Taxonomy Code
* Medically Fragile Infants and Children Day Care 261QM3000X

* Indicates primary specialty

NPI Profile & details for MAGNOLIA PEC, LLC

NPI Number 1053913442
Legal business name
LBN
MAGNOLIA PEC, LLC
Authorized official ELIZABETH BRISTER - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 11/11/2020
Last updated 02/28/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • MS Medicaid: 007828091

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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