Magnolia Bridge Home And Health Llc is a medicare enrolled "In Home Supportive Care" provider in Havelock, North Carolina. Their current practice location is
118 Realini Dr, Havelock, North Carolina. You can reach out to their office (for appointments etc.) via phone at
(252) 665-8819.
Magnolia Bridge Home And Health Llc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Magnolia Bridge Home And Health Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1811579758.
Healthcare Provider's Profile
| Full Name | Magnolia Bridge Home And Health Llc |
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| Type | Facility |
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| Speciality | In Home Supportive Care |
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| Location | 118 Realini Dr, Havelock, North Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1811579758
- Provider Enumeration Date: 04/21/2021
- Last Update Date: 03/11/2022
Medicare PECOS Information:
- PECOS PAC ID: 1850787672
- Enrollment ID: O20220404002635
Medical Identifiers
Medical identifiers for Magnolia Bridge Home And Health Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1811579758 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 253Z00000X | In Home Supportive Care | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Magnolia Bridge Home And Health Llc acts as a billing entity for following providers:
| Provider Name | Tracy L Hayes |
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| Provider Type | Practitioner - Occupational Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1578839403
PECOS PAC ID: 7113313933
Enrollment ID: I20220405002510 |
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| Provider Name | Shannon Marie Mays |
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| Provider Type | Practitioner - Occupational Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1568189397
PECOS PAC ID: 0840667473
Enrollment ID: I20221110001099 |
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| Provider Name | Maria Lourdes Ancheta Palma |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1477033611
PECOS PAC ID: 5698135614
Enrollment ID: I20230721000848 |
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| Provider Name | Robin K Digiacomo |
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| Provider Type | Practitioner - Qualified Speech Language Pathologist |
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| Provider Identifiers | NPI Number: 1548434855
PECOS PAC ID: 9537447222
Enrollment ID: I20230802001875 |
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| Provider Name | Terra Erdner |
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| Provider Type | Practitioner - Physical Therapist In Private Practice |
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| Provider Identifiers | NPI Number: 1770130338
PECOS PAC ID: 8820431331
Enrollment ID: I20240212001528 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Magnolia Bridge Home And Health Llc is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Magnolia Bridge Home And Health Llc
118 Realini Dr,
Havelock, NC 28532-9403
Ph: (252) 665-8819 | Magnolia Bridge Home And Health Llc
118 Realini Dr,
Havelock, NC 28532-9403
Ph: (252) 665-8819 |
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