Provider Type Icon

MAGNOLIA MEDICAL COMPANY NPI 1043769862


NPI Information

NPI: 1043769862
Provider Name: MAGNOLIA MEDICAL COMPANY
Classification: Internal Medicine - 207RA0401X
Entity Type: Organization

Specialization: Addiction Medicine

CLIA Number: 06D2115246

Address:
1850 RACE ST
DENVER, CO
ZIP 80206
Phone: (303) 209-5115
Get Directions

MAGNOLIA MEDICAL COMPANY is an addiction medicine internal medicine in Denver, CO. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. MAGNOLIA MEDICAL COMPANY NPI is 1043769862. The provider is registered as an organization entity type.

The provider's business location address is:

1850 RACE ST
DENVER, CO
ZIP 80206
Phone: (303) 209-5115

The provider's authorized official is Pradeep Raj Rai .
The authorized official title is Medical Director and has the following contact phone number (303) 209-5115.

The CLIA number assigned to this NPI record is 06D2115246 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/22/2016 and was last updated on 7/9/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1291U00000XClinical Medical Laboratory06D2121590COLORADONo
2208600000XSurgeryNo
3101YA0400XCounselorAddiction (Substance Use Disorder)No
4103T00000XPsychologistNo
5207R00000XInternal MedicineNo
6207RA0401XInternal MedicineAddiction MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.