Provider Demographics
NPI:1346867769
Name:NOBLE TELEHEALTH LLC
Entity Type:Organization
Organization Name:NOBLE TELEHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-675-2669
Mailing Address - Street 1:525 S INDEPENDENCE BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1188
Mailing Address - Country:US
Mailing Address - Phone:757-675-2669
Mailing Address - Fax:855-691-0403
Practice Address - Street 1:525 S INDEPENDENCE BLVD STE 120
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1188
Practice Address - Country:US
Practice Address - Phone:757-675-2669
Practice Address - Fax:855-691-0403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-01
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service