Provider Demographics
NPI:1659979797
Name:MAGNUM HEALTH, INC
Entity Type:Organization
Organization Name:MAGNUM HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHILOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-710-9953
Mailing Address - Street 1:712 SAINT ANDREWS BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7141
Mailing Address - Country:US
Mailing Address - Phone:843-766-0871
Mailing Address - Fax:843-763-7901
Practice Address - Street 1:712 SAINT ANDREWS BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7141
Practice Address - Country:US
Practice Address - Phone:843-766-0871
Practice Address - Fax:843-763-7901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty