Provider Demographics
NPI:1972294163
Name:NOBLE DRUG, INC.
Entity Type:Organization
Organization Name:NOBLE DRUG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:WELCH
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED PHARMACIS
Authorized Official - Phone:573-201-7430
Mailing Address - Street 1:521 E ELM ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:MO
Mailing Address - Zip Code:65536-3360
Mailing Address - Country:US
Mailing Address - Phone:573-201-7430
Mailing Address - Fax:
Practice Address - Street 1:521 E ELM ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:MO
Practice Address - Zip Code:65536-3360
Practice Address - Country:US
Practice Address - Phone:417-344-0586
Practice Address - Fax:855-532-5426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-17
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy