| Magnolia Wellness Group, Pc | |
|
1904 Eastwood Rd Ste 313 Wilmington NC 28403-5728 | |
| (910) 375-7500 | |
| Not Available |
| Full Name | Magnolia Wellness Group, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1904 Eastwood Rd Ste 313, Wilmington, North Carolina |
| Authorized Official Name and Position | Jeffrey Litzinger (MEDICAL DIRECTOR) |
| Authorized Official Contact | 9103757500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Wellness Group, Pc 809 Wild Turkey Pl Wilmington NC 28405-4265 Ph: (910) 375-7500 | Magnolia Wellness Group, Pc 1904 Eastwood Rd Ste 313 Wilmington NC 28403-5728 Ph: (910) 375-7500 |
| NPI Number | 1982175469 |
|---|---|
| Provider Enumeration Date | 12/10/2018 |
| Last Update Date | 06/11/2019 |
| Medicare PECOS PAC ID | 6204276140 |
|---|---|
| Medicare Enrollment ID | O20240425003064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982175469 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Natalie David |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235580853 PECOS PAC ID: 7012357957 Enrollment ID: I20240425003138 |
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