Provider Demographics
NPI:1841686490
Name:LAWRENCE NOBLE ENTERPRISES, INC.
Entity type:Organization
Organization Name:LAWRENCE NOBLE ENTERPRISES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-408-4544
Mailing Address - Street 1:1734 ELTON RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1724
Mailing Address - Country:US
Mailing Address - Phone:301-408-4544
Mailing Address - Fax:301-408-7554
Practice Address - Street 1:1734 ELTON RD
Practice Address - Street 2:SUITE 112
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1724
Practice Address - Country:US
Practice Address - Phone:301-408-4544
Practice Address - Fax:301-408-7554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-10
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service