Provider Demographics
NPI:1306394077
Name:MSNRC OPS, INC.
Entity Type:Organization
Organization Name:MSNRC OPS, INC.
Other - Org Name:MAGNOLIA SQUARE NURSING AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-932-0050
Mailing Address - Street 1:1502 W EDGEWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-3567
Mailing Address - Country:US
Mailing Address - Phone:417-877-7545
Mailing Address - Fax:417-877-7551
Practice Address - Street 1:1502 W EDGEWOOD ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-3567
Practice Address - Country:US
Practice Address - Phone:417-877-7545
Practice Address - Fax:417-877-7551
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RHC OPERATIONS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-12
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO101491405Medicaid
MO044662OtherFACILITY LICENSE
MO265731Medicare Oscar/Certification