Provider Demographics
NPI:1659488864
Name:NOBEL MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:NOBEL MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:UDOEKPO
Authorized Official - Middle Name:NATHANIEL
Authorized Official - Last Name:EKPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-873-0712
Mailing Address - Street 1:111 E RIALTO AVE
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-6509
Mailing Address - Country:US
Mailing Address - Phone:909-873-0712
Mailing Address - Fax:909-873-0779
Practice Address - Street 1:111 E RIALTO AVE
Practice Address - Street 2:
Practice Address - City:RIALTO
Practice Address - State:CA
Practice Address - Zip Code:92376-6509
Practice Address - Country:US
Practice Address - Phone:909-873-0712
Practice Address - Fax:909-873-0779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332BN1400332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4810360001Medicare ID - Type UnspecifiedDME03061G