Provider Demographics
NPI:1275869364
Name:WHITE MAGNOLIA SERVICES INC
Entity Type:Organization
Organization Name:WHITE MAGNOLIA SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:FALK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-756-3445
Mailing Address - Street 1:9009 ALBEMARLE RD
Mailing Address - Street 2:SUITE 101-385
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-2600
Mailing Address - Country:US
Mailing Address - Phone:704-756-3445
Mailing Address - Fax:
Practice Address - Street 1:9009 ALBEMARLE RD
Practice Address - Street 2:SUITE 101-385
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-2600
Practice Address - Country:US
Practice Address - Phone:704-756-3445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC21772207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty