Provider Demographics
NPI:1356182901
Name:NIMBA HOLDINGS, LLC
Entity type:Organization
Organization Name:NIMBA HOLDINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZENGBEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-394-5554
Mailing Address - Street 1:3343 BRACHENBURY LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-3709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4955 SUMMIT ARBOR DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-3337
Practice Address - Country:US
Practice Address - Phone:424-394-5554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No335G00000XSuppliersMedical Foods Supplier