NPI 1538204094

Magnolia Manor at Tupelo

Organisation Exclusive Provider Organization Belden, MS

Practice location

Address: 5427a Fain Ln, Belden, MS 38826-9214
Phone: (662) 397-2733

Authorised official

Name: Debra D Haynes
Title: Director Administrative Services
Phone: (662) 842-6776

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 1000 (MS)

Other Exclusive Provider Organization providers in Mississippi →

Registry record

NPI: 1538204094
Entity type: Organization
NPI issued: 21 Feb 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.