1841686490 NPI number — LAWRENCE NOBLE ENTERPRISES, INC.

Table of content: (NPI 1841686490)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841686490 NPI number — LAWRENCE NOBLE ENTERPRISES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAWRENCE NOBLE ENTERPRISES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841686490
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/10/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1734 ELTON RD
Provider Second Line Business Mailing Address:
SUITE 112
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20903-1724
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-408-4544
Provider Business Mailing Address Fax Number:
301-408-7554

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1734 ELTON RD
Provider Second Line Business Practice Location Address:
SUITE 112
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20903-1724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-408-4544
Provider Business Practice Location Address Fax Number:
301-408-7554
Provider Enumeration Date:
04/10/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NOBLE
Authorized Official First Name:
MARK
Authorized Official Middle Name:
LAWRENCE
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
301-408-4544

Provider Taxonomy Codes

  • Taxonomy code: 261QH0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)