Provider Demographics
NPI:1720349707
Name:NOBLE MOBILE
Entity Type:Organization
Organization Name:NOBLE MOBILE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:REBEL
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-274-2168
Mailing Address - Street 1:1231 CUMBERLAND AVE STE F
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47906-1358
Mailing Address - Country:US
Mailing Address - Phone:765-274-2168
Mailing Address - Fax:888-977-5375
Practice Address - Street 1:1231 CUMBERLAND AVE STE F
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-1358
Practice Address - Country:US
Practice Address - Phone:765-274-2168
Practice Address - Fax:888-977-5375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)