MAGNOLIA HOSPICE, LLC (NPI# 1396169074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396169074 |
| Entity Type | Organization |
| Organization Name | MAGNOLIA HOSPICE, LLC |
| Practice Address |
1374 Manchester Dr Ne Conyers GA 30012-3881 |
| Practice Telephone | 7704839111 |
| Practice Fax Number | 8776638423 |
| Mailing Telephone | 7704839111 |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2018-05-02 |
| Authorized Official Name | DANIEL EDWARDS (CEO) |
| Authorized Official Telephone | 4702818686 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251G00000X | Hospice Care, Community Based | Agencies | ||
| Y | 315D00000X | Hospice, Inpatient | 122-0392-H | GA | Nursing & Custodial Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790159358 | Magnolia Hospice, LLC | Hospice Care, Community Based | 12120 Colonel Glenn Rd, Suite 10000, Little Rock, AR 72210-2824 | 2015-11-19 |
| Street Address |
1374 MANCHESTER DR NE |
| City | CONYERS |
| State | GA |
| Zip Code | 30012-3881 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588625925 | Hillcrest Hospice, Inc | Hospice Care, Community Based | 1374 Manchester Dr Ne, Conyers, GA 30012-3881 | 2006-03-28 |
| 1831145424 | In Home Health LLC | Hospice, Inpatient | 1374 Manchester Dr Ne, Conyers, GA 30012-3881 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
| 1043855836 | Maurvet Minto | Counselor | 1175 Green St, Conyers, Conyers, GA 30012 | 2019-11-15 |
| 1770054561 | Sarah Elizabeth Brooks | Physical Medicine & Rehabilitation | 1290 Milstead Ave Ne, Conyers, GA 30012 | 2018-12-06 |
| 1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
| 1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
| 1558813295 | Salon Lyon, LLC | Specialist | 1112 West Ave, Se, B, Conyers, GA 30012 | 2016-10-28 |
| 1992252753 | Traci Hunter Bryan | Pharmacist | 1501 Milstead Ave Ne, Suite 110, Conyers, GA 30012 | 2016-09-08 |
| 1316491830 | Hye Rim Kim | Anesthesiologist Assistant | 1380 Milstead Rd Ne, Suite G, Conyers, GA 30012 | 2016-08-12 |
| 1235591397 | David Jeffrey Wasserman | Optometrist | 1192 Dogwood Dr Sw, Conyers, GA 30012 | 2016-03-28 |
| 1174919187 | Anique Archer | Health Educator | 2170 Lester Rd Nw, Conyers, GA 30012 | 2015-04-07 |
| Find all providers in zip 30012 | ||||
| Taxonomy Code | 315D00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Hospice, Inpatient |
| A provider organization, or distinct part of the organization, which renders an interdisciplinary program providing palliative care, chiefly medical relief of pain and supporting services, which addresses the emotional, social, financial, and legal needs of terminally ill patients and their families where an institutional care environment is required for the patient. |
| Notes: Source: AHA Guide, American Hospital Association. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831145424 | In Home Health LLC | Hospice, Inpatient | 1374 Manchester Dr Ne, Conyers, GA 30012-3881 | 2006-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800901 | Reliant Haven Healthcare | Hospice, Inpatient | 5721 Suffex Green Ln, Atlanta, GA 30339-6117 | 2020-08-04 |
| 1912489741 | Sacred Journey Hospice, Inc. | Hospice, Inpatient | 4165 Old Milton Pkwy Ste 200, Alpharetta, GA 30005-4478 | 2018-08-29 |
| 1427548676 | Sacred Journey Hospice, Inc. | Hospice, Inpatient | 60 Oak Hill Blvd Ste 203, Newnan, GA 30265-2314 | 2018-05-14 |
| 1811448319 | Butterfly Gardens Hospice & Palliative Care | Hospice, Inpatient | 3112 Blackmon Court, Hephzibah, GA 30815 | 2016-10-19 |
| 1376991000 | Eatonton Facility Development Company, LLC | Hospice, Inpatient | 155 Greensboro Rd, Eatonton, GA 31021 | 2016-06-03 |
| 1104221209 | Arcadia Hospice, LLC | Hospice, Inpatient | 119 Canal St Ste 103, Pooler, GA 31322 | 2014-10-31 |
| 1306276498 | Mt Berry Hospice Inc. | Hospice, Inpatient | 4300 Martha Berry Hwy Ne, Rome, GA 30165-8642 | 2013-11-26 |
| 1467746875 | Healing Hands | Hospice, Inpatient | 2667 C St, Macon, GA 31206-8307 | 2011-06-02 |
| 1982882114 | Serenity Hospice Care LLC | Hospice, Inpatient | 1057 N Houston Rd, Warner Robins, GA 31093-1563 | 2008-02-11 |
| 1518088038 | St. David Hospice | Hospice, Inpatient | 6101 Brixworth Pl Ne, Atlanta, GA 30319-5327 | 2007-04-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.