NPI 1558545210

Magnolia Manor of Tupelo

Organisation Preferred Provider Organization Tupelo, MS

Practice location

Address: 1514 County Road 41, Tupelo, MS 38801-0681
Phone: (662) 842-6776
Fax: (662) 842-6512

Authorised official

Name: Donna Pharr
Title: Executive Director
Phone: (662) 842-6776

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 1000 (MS)

Other Preferred Provider Organization providers in Mississippi →

Registry record

NPI: 1558545210
Entity type: Organization
NPI issued: 18 Dec 2007
Record last updated: 18 Dec 2007

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.