Provider Demographics
NPI:1740219914
Name:NABBIE INC
Entity Type:Organization
Organization Name:NABBIE INC
Other - Org Name:VILLAGE SHOEMAKER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:U
Authorized Official - Last Name:GLAZIER
Authorized Official - Suffix:SR
Authorized Official - Credentials:CPED
Authorized Official - Phone:801-224-1470
Mailing Address - Street 1:55 WEST CENTER ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057
Mailing Address - Country:US
Mailing Address - Phone:801-224-1470
Mailing Address - Fax:801-224-1990
Practice Address - Street 1:55 WEST CENTER ST
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057
Practice Address - Country:US
Practice Address - Phone:801-224-1470
Practice Address - Fax:801-224-1990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
5627500001Medicare NSC