National Provider Identifier Database

MAGNOLIA HEALTH CARE LLC
Wound Care


Contact Information

MAGNOLIA HEALTH CARE LLC
2407 BANEBERRY LN
GAMBRILLS, MD21054-1992
Phone: 410-793-2634
Fax:
Website:
Specialty Taxonomy Code
* Wound Care 163WW0000X
Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for MAGNOLIA HEALTH CARE LLC

NPI Number 1225908445
Legal business name
LBN
MAGNOLIA HEALTH CARE LLC
Authorized official SHAQUILLA VAZQUEZ CLARK - (OWNER)
Entity Organization
Organization subpart Yes
Enumeration date 11/11/2025
Last updated 01/02/2026 - About 5 months ago
Sole proprietor1 Not specified
Identifiers n/a

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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