Provider Demographics
NPI:1871367599
Name:MAGNA VENTURES LLC
Entity type:Organization
Organization Name:MAGNA VENTURES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-496-5391
Mailing Address - Street 1:201 RIO GRANDE DR
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-2460
Mailing Address - Country:US
Mailing Address - Phone:417-496-5391
Mailing Address - Fax:
Practice Address - Street 1:201 RIO GRANDE DR
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-2460
Practice Address - Country:US
Practice Address - Phone:417-496-5391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No344600000XTransportation ServicesTaxi
No347B00000XTransportation ServicesBus
No347C00000XTransportation ServicesPrivate Vehicle